Provider Demographics
NPI:1992428015
Name:POLIS, TERRA (MS CCC-SLP)
Entity type:Individual
Prefix:
First Name:TERRA
Middle Name:
Last Name:POLIS
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:TERRA
Other - Middle Name:
Other - Last Name:REINLIE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:11111 TELGE RD
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77429-3390
Mailing Address - Country:US
Mailing Address - Phone:281-897-4700
Mailing Address - Fax:
Practice Address - Street 1:11111 TELGE RD
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77429-3390
Practice Address - Country:US
Practice Address - Phone:281-897-4700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-23
Last Update Date:2024-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX120118235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist