Healthcare Provider Details

I. General information

NPI: 1760089940
Provider Name (Legal Business Name): PAMELA A. CAIL MS, APRN, AGNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/01/2020
Last Update Date: 10/01/2020
Certification Date: 09/22/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5500 SOUTHWESTERN MEDICAL AVE
DALLAS TX
75235-7299
US

IV. Provider business mailing address

13608 HICKORY CREEK DR
HASLET TX
76052-2432
US

V. Phone/Fax

Practice location:
  • Phone: 214-689-6500
  • Fax:
Mailing address:
  • Phone: 817-300-1742
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAP145983
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: