Provider Demographics
NPI:1568603140
Name:MATIJEVICH, PAMELA (PA-C)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:
Last Name:MATIJEVICH
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4714 FM 1488 RD STE 132
Mailing Address - Street 2:
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77384-4930
Mailing Address - Country:US
Mailing Address - Phone:877-868-2528
Mailing Address - Fax:877-926-5332
Practice Address - Street 1:4714 FM 1488 RD STE 132
Practice Address - Street 2:
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77384
Practice Address - Country:US
Practice Address - Phone:877-868-2528
Practice Address - Fax:877-926-5332
Is Sole Proprietor?:No
Enumeration Date:2009-03-12
Last Update Date:2019-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant