Provider Demographics
NPI:1720899529
Name:POLLARD RENEAU, TERA (DIAGNOSTICIAN)
Entity type:Individual
Prefix:
First Name:TERA
Middle Name:
Last Name:POLLARD RENEAU
Suffix:
Gender:F
Credentials:DIAGNOSTICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6414 TIMARRON LAKES DR
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77493-4287
Mailing Address - Country:US
Mailing Address - Phone:661-576-0399
Mailing Address - Fax:
Practice Address - Street 1:6414 TIMARRON LAKES DR
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77493-4287
Practice Address - Country:US
Practice Address - Phone:661-576-0399
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-20
Last Update Date:2025-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2320375103TM1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental Disabilities