Provider Demographics
NPI:1447584230
Name:HLIPALA, PAMELA GAYLE
Entity Type:Individual
Prefix:MS
First Name:PAMELA
Middle Name:GAYLE
Last Name:HLIPALA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:PAMELA
Other - Middle Name:GAYLE
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PTA
Mailing Address - Street 1:4718 HALLMARK DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77056-3909
Mailing Address - Country:US
Mailing Address - Phone:713-622-2929
Mailing Address - Fax:713-622-2922
Practice Address - Street 1:4718 HALLMARK DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77056-3909
Practice Address - Country:US
Practice Address - Phone:713-622-2929
Practice Address - Fax:713-622-2922
Is Sole Proprietor?:No
Enumeration Date:2009-09-25
Last Update Date:2009-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX02070979225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00W860Medicare UPIN