MEDICARE: PAMELA ELISA LOMBANA NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0200X	Pediatric Nurse Practitioner	AP109276	TX
2	363L00000X	Nurse Practitioner	AP109276	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	01245176	OTHER	TX	AMERIGROUP
3	186523003	OTHER	TX	TX HEALTHSTEPS EPDST
4	260699437	OTHER	TX	TAX ID

General Provider Information

NPI Number	:	1578692927
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAMELA ELISA LOMBANA NP

Provider Business Mailing Address
First Line	:	2323 WIRT RD STE F
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77055-1232
Country	:	US
Telephone Number	:	713-467-4900
Fax Number	:

Provider Business Practice Location Address
First Line	:	2323 WIRT RD STE F
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77055-1232
Country	:	US
Telephone Number	:	713-467-4900
Fax Number	:	713-467-6006

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/03/2007
Last Update Date	:	10/06/2025

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