Provider Demographics
NPI:1669623948
Name:ESTOK, PAMELA VALARIE
Entity type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:VALARIE
Last Name:ESTOK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:308 FORREST DR
Mailing Address - Street 2:
Mailing Address - City:NEWPORT
Mailing Address - State:AR
Mailing Address - Zip Code:72112-4025
Mailing Address - Country:US
Mailing Address - Phone:870-523-3644
Mailing Address - Fax:870-523-8224
Practice Address - Street 1:1507 N PECAN ST
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:AR
Practice Address - Zip Code:72112-2867
Practice Address - Country:US
Practice Address - Phone:870-523-3644
Practice Address - Fax:870-523-8224
Is Sole Proprietor?:No
Enumeration Date:2008-10-06
Last Update Date:2008-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator