Provider Demographics
NPI:1225317605
Name:KENDALL, PAMELA RACHELE (DC)
Entity Type:Individual
Prefix:DR
First Name:PAMELA
Middle Name:RACHELE
Last Name:KENDALL
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:190 S PEYTONVILLE AVE
Mailing Address - Street 2:SUITE 120
Mailing Address - City:SOUTHLAKE
Mailing Address - State:TX
Mailing Address - Zip Code:76092-6937
Mailing Address - Country:US
Mailing Address - Phone:817-488-6888
Mailing Address - Fax:817-488-5888
Practice Address - Street 1:190 S PEYTONVILLE AVE
Practice Address - Street 2:SUITE 120
Practice Address - City:SOUTHLAKE
Practice Address - State:TX
Practice Address - Zip Code:76092-6937
Practice Address - Country:US
Practice Address - Phone:817-488-6888
Practice Address - Fax:817-488-5888
Is Sole Proprietor?:No
Enumeration Date:2011-08-16
Last Update Date:2011-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9457111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor