Provider Demographics
NPI:1558370171
Name:LAROCHELLE, PAMELA A (PA-C)
Entity Type:Individual
Prefix:MS
First Name:PAMELA
Middle Name:A
Last Name:LAROCHELLE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 GREENWAY PLZ
Mailing Address - Street 2:SUITE 2950
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77046-0905
Mailing Address - Country:US
Mailing Address - Phone:866-607-7334
Mailing Address - Fax:713-358-4801
Practice Address - Street 1:130 SAWDUST RD
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77380-2272
Practice Address - Country:US
Practice Address - Phone:281-419-3162
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2008-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA04472363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8Y3683OtherBCBSTX
TX8Y3683OtherBCBSTX