Provider Demographics
NPI:1790938108
Name:METOYER, PAMELA SMITH (NP)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:SMITH
Last Name:METOYER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11602 PARK FALLS CT
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-7219
Mailing Address - Country:US
Mailing Address - Phone:832-814-3883
Mailing Address - Fax:
Practice Address - Street 1:14455 CULLEN BLVD
Practice Address - Street 2:SUITE C-2
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77047-4800
Practice Address - Country:US
Practice Address - Phone:713-734-0700
Practice Address - Fax:713-734-2394
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-29
Last Update Date:2008-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX551891363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX551891OtherR.N. NURSE PRACTITIONER