| Ms Polly Jewell Logan, CNM | |
|
201 Kingwood Medical Dr., Suite B-300, Kingwood, TX 77339 | |
| (281) 359-2229 | |
| Not Available |
| Full Name | Ms Polly Jewell Logan |
|---|---|
| Gender | Female |
| Speciality | Advanced Practice Midwife |
| Location | 201 Kingwood Medical Dr., Kingwood, Texas |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215063987 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 367A00000X | Advanced Practice Midwife | 516618 (Texas) | Primary |
| Entity Name | Texas Childrens Physician Group |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1861675506 PECOS PAC ID: 4385722081 Enrollment ID: O20080422000209 |
| Entity Name | Dhhs Ihs Phoenix Area |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1427335140 PECOS PAC ID: 2668649567 Enrollment ID: O20120117000781 |
| Entity Name | Obhg Texas Holdings Pa |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1083917769 PECOS PAC ID: 3577713072 Enrollment ID: O20121018000279 |
| Entity Name | Acclaim Physician Group Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1780076562 PECOS PAC ID: 4587963582 Enrollment ID: O20160426000707 |
| Mailing Address | Practice Location Address |
|---|---|
| Ms Polly Jewell Logan, CNM 13523 Hargrave Rd, Houston, TX 77070-3829 Ph: (281) 206-4496 | Ms Polly Jewell Logan, CNM 201 Kingwood Medical Dr., Suite B-300, Kingwood, TX 77339 Ph: (281) 359-2229 |
Stephanie Gotcher, CNM Advanced Practice Midwife Medicare: Medicare Enrolled Practice Location: 19701 Kingwood Dr Bldg 5, Kingwood, TX 77339 Phone: 281-319-8101 | |
Janet Little, CNM Advanced Practice Midwife Medicare: Not Enrolled in Medicare Practice Location: 201 Kingwood Medical Dr Ste B300, Kingwood, TX 77339 Phone: 281-359-2229 Fax: 281-359-8823 | |
Karen Petrusic Mcneal, APRN, CNM Advanced Practice Midwife Medicare: Medicare Enrolled Practice Location: 350 Kingwood Medical Dr Ste 350, Kingwood, TX 77339 Phone: 281-359-7000 |