Provider Demographics
NPI:1578200978
Name:KLEIN, PAMELA J (MS-HNFM, CNS-CANIDAT)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:J
Last Name:KLEIN
Suffix:
Gender:F
Credentials:MS-HNFM, CNS-CANIDAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:418 COUNTY ROAD 2788
Mailing Address - Street 2:
Mailing Address - City:SUNSET
Mailing Address - State:TX
Mailing Address - Zip Code:76270-3300
Mailing Address - Country:US
Mailing Address - Phone:940-627-5055
Mailing Address - Fax:940-627-5058
Practice Address - Street 1:418 COUNTY ROAD 2788
Practice Address - Street 2:
Practice Address - City:SUNSET
Practice Address - State:TX
Practice Address - Zip Code:76270-3300
Practice Address - Country:US
Practice Address - Phone:940-627-5055
Practice Address - Fax:940-627-5058
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-17
Last Update Date:2022-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133N00000XDietary & Nutritional Service ProvidersNutritionistGroup - Single Specialty