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Individual

PAMELA SHAVONNE GARCIA-JACKSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1910 MEDI PARK DR, AMARILLO, TX 79106-2187
(806) 457-4700
Mailing address
105 BANKS DR, AMARILLO, TX 79124-3025
(806) 517-8711

Taxonomy

Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
2053876
TX
225200000X
Physical Therapy Assistant
Primary
2053876
TX

Other

Enumeration date
02/01/2021
Last updated
02/04/2021
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