Provider Demographics
NPI:1114938370
Name:MORGAN, PAMELA DAWN (NP)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:DAWN
Last Name:MORGAN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3023 MARINA BAY DR STE 103
Mailing Address - Street 2:
Mailing Address - City:LEAGUE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77573-2882
Mailing Address - Country:US
Mailing Address - Phone:281-538-1003
Mailing Address - Fax:281-535-2240
Practice Address - Street 1:3023 MARINA BAY DR STE 103
Practice Address - Street 2:
Practice Address - City:LEAGUE CITY
Practice Address - State:TX
Practice Address - Zip Code:77573-2882
Practice Address - Country:US
Practice Address - Phone:281-538-1003
Practice Address - Fax:281-535-2240
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-11
Last Update Date:2019-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX540686363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXQ32354Medicare UPIN
TX8J2083Medicare PIN