Provider Demographics
NPI:1760089940
Name:CAIL, PAMELA A (MS, APRN, AGNP-C)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:A
Last Name:CAIL
Suffix:
Gender:F
Credentials:MS, APRN, AGNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13608 HICKORY CREEK DR
Mailing Address - Street 2:
Mailing Address - City:HASLET
Mailing Address - State:TX
Mailing Address - Zip Code:76052-2432
Mailing Address - Country:US
Mailing Address - Phone:817-300-1742
Mailing Address - Fax:
Practice Address - Street 1:5500 SOUTHWESTERN MEDICAL AVE
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75235-7299
Practice Address - Country:US
Practice Address - Phone:214-689-6500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-01
Last Update Date:2020-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP145983363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health