Provider Demographics
NPI:1013400050
Name:GRIFFIN, PAMELA P
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:P
Last Name:GRIFFIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10119 RAMBLIN RIVER RD
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78251-4351
Mailing Address - Country:US
Mailing Address - Phone:210-793-6164
Mailing Address - Fax:
Practice Address - Street 1:10119 RAMBLIN RIVER RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78251-4351
Practice Address - Country:US
Practice Address - Phone:210-793-6164
Practice Address - Fax:210-793-6164
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-13
Last Update Date:2018-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management