Provider Demographics
NPI:1558400994
Name:DAWSON, PAMELA J (RD,RN)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:J
Last Name:DAWSON
Suffix:
Gender:F
Credentials:RD,RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:48 MCLELLAND BLVD
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78520-7422
Mailing Address - Country:US
Mailing Address - Phone:956-346-0878
Mailing Address - Fax:
Practice Address - Street 1:48 MCLELLAND BLVD
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78520-7422
Practice Address - Country:US
Practice Address - Phone:956-346-0878
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT06418133V00000X
TX606206163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Not Answered163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXDT06418OtherLICENSED DIETITIAN
TX606206OtherREGISTERED NURSE
610690OtherREGISTERED DIETITIAN