Provider Demographics
NPI:1114378197
Name:POWLEY, PAMELA SUE (LVN)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:SUE
Last Name:POWLEY
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7428 PARK PLACE BLVD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77087-4442
Mailing Address - Country:US
Mailing Address - Phone:713-645-6303
Mailing Address - Fax:713-643-2967
Practice Address - Street 1:7428 PARK PLACE BLVD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77087-4442
Practice Address - Country:US
Practice Address - Phone:713-645-6303
Practice Address - Fax:713-643-2967
Is Sole Proprietor?:No
Enumeration Date:2016-06-30
Last Update Date:2016-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX82377164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse