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Contact Information

KENDALL POLK, CSFA
205 CRENSHAW DR
MANSFIELD, TX76063-3451
 Phone: 214-927-6539
 Fax: 817-394-1231
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Surgical Assistant

246ZC0007X
 

Orthopaedic Assistant

246ZX2200X
 

Surgery

208600000X 02 Physician/General Surgery
Indicates primary specialty

NPI Profile & details for KENDALL POLK · (Male)

NPI # 1285009803
Status Active
Credentials CSFA
Entity Individual
Enumeration date 12/08/2015
Last updated 06/16/2018 - About 8 years ago
Sole proprietor 1 Yes
Identifiers
  • TX License # SA00635
  • Other 1225495708 NPI
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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