Provider Demographics
NPI:1184920126
Name:PADGETT, PAMELA (MED, LPC, RPT, RN)
Entity type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:
Last Name:PADGETT
Suffix:
Gender:F
Credentials:MED, LPC, RPT, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9201 GROGAN'S MILL RD.
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77380
Mailing Address - Country:US
Mailing Address - Phone:281-466-8602
Mailing Address - Fax:
Practice Address - Street 1:9201 GROGANS MILL RD
Practice Address - Street 2:
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77380-3621
Practice Address - Country:US
Practice Address - Phone:281-466-8602
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-09
Last Update Date:2011-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX64493101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health