Individual
PAMELA D MACKAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
2026 S JACKSON ST, JACKSONVILLE, TX 75766-5822
(903) 586-5678
Mailing address
PO BOX 847522, DALLAS, TX 75284-7522
(903) 531-5000
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP132740
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
369920901
—
TX
05
—
369920902
—
TX
01
—
552857YMAF
MEDICARE
TX
01
—
75-1976930-005
TRICARE
TX
01
—
752616977020
TRICARE
TX
01
—
8462MB
BCBS
TX
01
—
8HL389
BCBS
TX
01
—
P01787234
RAIL ROAD MEDICARE
TX
01
—
P01938229
MEDICARE RAIL ROAD
TX
Enumeration date
12/12/2016
Last updated
02/16/2018
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