Provider Demographics
NPI:1972516128
Name:MCCARTHY, PAMELA ANN (RN, ONP)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:ANN
Last Name:MCCARTHY
Suffix:
Gender:F
Credentials:RN, ONP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1515 HOLCOMBE BLVD
Mailing Address - Street 2:UNIT 1354
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-4000
Mailing Address - Country:US
Mailing Address - Phone:713-794-5188
Mailing Address - Fax:713-563-0905
Practice Address - Street 1:1515 HOLCOMBE BLVD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-4009
Practice Address - Country:US
Practice Address - Phone:713-792-6161
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-15
Last Update Date:2013-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX727343363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8Y0539OtherBCBS
TX183124001Medicaid
TX8G8232Medicare PIN