Provider Demographics
NPI:1659312312
Name:MEYER, PAMELA SUE (OT, CHT)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:SUE
Last Name:MEYER
Suffix:
Gender:F
Credentials:OT, CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:402 W WINDCREST ST
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78624-4465
Mailing Address - Country:US
Mailing Address - Phone:830-997-1357
Mailing Address - Fax:830-990-6163
Practice Address - Street 1:402 W WINDCREST ST
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:TX
Practice Address - Zip Code:78624-4465
Practice Address - Country:US
Practice Address - Phone:830-997-1357
Practice Address - Fax:830-990-6163
Is Sole Proprietor?:No
Enumeration Date:2006-06-10
Last Update Date:2023-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX109127225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8T3234OtherBCBS
TX2370773OtherCIGNA
TX3754129OtherAETNA
TX8T3234OtherBCBS