Provider Demographics
NPI:1457845695
Name:POLACHEK, WILLIAM STEPHEN (MD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:STEPHEN
Last Name:POLACHEK
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2901 ACME BRICK PLZ
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76109-4124
Mailing Address - Country:US
Mailing Address - Phone:817-529-1900
Mailing Address - Fax:817-529-1910
Practice Address - Street 1:1320 US-287
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:TX
Practice Address - Zip Code:76063
Practice Address - Country:US
Practice Address - Phone:817-968-5806
Practice Address - Fax:915-703-7745
Is Sole Proprietor?:No
Enumeration Date:2018-06-20
Last Update Date:2024-11-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXU0418207XX0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0004XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryFoot and Ankle Surgery