Provider Demographics
NPI:1114040961
Name:OZOWALU, PAMELA (DNP, APRN, PMHNP-BC)
Entity Type:Individual
Prefix:DR
First Name:PAMELA
Middle Name:
Last Name:OZOWALU
Suffix:
Gender:F
Credentials:DNP, APRN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12915 JONES MALTSBERGER RD STE 102
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78247-4255
Mailing Address - Country:US
Mailing Address - Phone:210-372-7448
Mailing Address - Fax:
Practice Address - Street 1:12915 JONES MALTSBERGER RD STE 102
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78247-4255
Practice Address - Country:US
Practice Address - Phone:210-372-7448
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-09
Last Update Date:2019-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX816501363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health