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General NPI Number Information
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NPI Number | 1437379245
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Entity Type | Organization
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Legal Business Name | PAMELA A. MCQUILLIN, M.D., P.A.
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Dates
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Enumeration Date | 04/26/2007
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Last Update Date | 02/12/2014
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Provider Practice Location Address
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Address Line | 1330 E 8TH ST STE 420
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City | ODESSA
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State | TX
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Zip | 79761-4733
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Country | US
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Telephone | 432-580-9191
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Fax | 432-332-1344
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Provider Business Mailing Address
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Address Line | 1330 E 8TH ST STE 420
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City | ODESSA
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State | TX
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Zip | 79761-4733
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Country | US
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Telephone | 432-580-9191
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Fax | 432-332-1344
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. PAMELA A. MCQUILLIN
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Credential | M.D.
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Telephone | 432-580-9191
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | L1389
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License Number State | TX
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