Provider Demographics
NPI:1548713233
Name:MONTENEGRO, PAMELA NOELLE (NP)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:NOELLE
Last Name:MONTENEGRO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7624 WARREN PKWY
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-4158
Mailing Address - Country:US
Mailing Address - Phone:956-389-6565
Mailing Address - Fax:956-389-6567
Practice Address - Street 1:2101 PEASE ST
Practice Address - Street 2:
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78550-8307
Practice Address - Country:US
Practice Address - Phone:956-389-6565
Practice Address - Fax:956-389-6567
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-28
Last Update Date:2024-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001249311163W00000X
VA0024173787363L00000X
TX1018111363LG0600X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology