Individual
PAMALA J EDWARDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
700 FLOURNOY RD, SUITE 2A, ALICE, TX 78332-4003
(361) 664-1417
(361) 664-3218
Mailing address
204 E 1ST ST, ALICE, TX 78332-4822
(361) 664-0145
(361) 664-2248
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA02621
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
063476801
—
TX
05
—
312414101
—
TX
01
—
8J3360
MEDICARE PARTB FOR COMMUNITY ACTION
TX
Enumeration date
11/02/2006
Last updated
08/30/2018
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