Provider Demographics
NPI:1336308956
Name:GARCIA, PAMELA M (FNP-C, ACNP-BC)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:M
Last Name:GARCIA
Suffix:
Gender:F
Credentials:FNP-C, ACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 845347
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-5347
Mailing Address - Country:US
Mailing Address - Phone:469-291-3369
Mailing Address - Fax:214-645-0078
Practice Address - Street 1:5323 HARRY HINES BLVD STOP 7200
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75390-4427
Practice Address - Country:US
Practice Address - Phone:214-648-6400
Practice Address - Fax:214-648-5461
Is Sole Proprietor?:No
Enumeration Date:2008-06-09
Last Update Date:2021-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX650427363L00000X, 363LF0000X
TXAP115969363LA2100X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX197182201Medicaid
TX687276OtherST LIC #
TX687276OtherST LIC #