MEDICARE: PAMELA A. MCQUILLIN, M.D., P.A.

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	207V00000X	Obstetrics & Gynecology Physician	L1389	TX

General Provider Information

NPI Number	:	1437379245
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PAMELA A. MCQUILLIN, M.D., P.A.

Provider Business Mailing Address
First Line	:	1330 E 8TH ST STE 420
Second Line	:
City	:	ODESSA
State	:	TX
Zip	:	79761-4733
Country	:	US
Telephone Number	:	432-580-9191
Fax Number	:	432-332-1344

Provider Business Practice Location Address
First Line	:	1330 E 8TH ST STE 420
Second Line	:
City	:	ODESSA
State	:	TX
Zip	:	79761-4733
Country	:	US
Telephone Number	:	432-580-9191
Fax Number	:	432-332-1344

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. PAMELA A. MCQUILLIN
Credential	:	M.D.
Telephone Number	:	432-580-9191

Provider Enumeration Date	:	04/26/2007
Last Update Date	:	02/12/2014

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