Provider Demographics
NPI:1346440492
Name:SALDANA JENTZ, PAMELA A (OT)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:A
Last Name:SALDANA JENTZ
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:PAMELA
Other - Middle Name:A
Other - Last Name:JENTZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:3200 TROUP HWY
Mailing Address - Street 2:SUITE 333
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75701-8397
Mailing Address - Country:US
Mailing Address - Phone:903-535-5055
Mailing Address - Fax:903-535-5066
Practice Address - Street 1:3200 TROUP HWY
Practice Address - Street 2:SUITE 333
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75701-8397
Practice Address - Country:US
Practice Address - Phone:903-535-5055
Practice Address - Fax:903-535-5066
Is Sole Proprietor?:No
Enumeration Date:2007-07-18
Last Update Date:2007-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX104623225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist