Pamela Ross Breazeale, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

693121 Issued in TX

Practice address

117 Cumberland Gap
Victoria, TX 77904-2416

Phone

(361) 676-1678

NPI assigned

Oct 7, 2011

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Citizen'S Medical Center County of Victoria

  • Multi-Specialty Clinic/Center
  • Victoria, TX
  • NPI 1205242088

  Family

  Medicare reassignment NPD
• Citizens Medical Center County of Victoria

  • General Acute Care Hospital
  • Victoria, TX
  • NPI 1124052162
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1317945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317945600000",
    "number": "1346524303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 CUMBERLAND GAP",
            "city": "VICTORIA",
            "state": "TX",
            "postal_code": "779042416",
            "telephone_number": "361-676-1678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 CUMBERLAND GAP",
            "city": "VICTORIA",
            "state": "TX",
            "postal_code": "779042416",
            "telephone_number": "361-676-1678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREAZEALE",
        "first_name": "PAMELA",
        "middle_name": "ROSS",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-10-07",
        "last_updated": "2011-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "693121",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Antonio Carvalho Braga, MD
• Irma Alicia Brand, NP
• James Rutland Brand, MD
• Gary S Branfman, MD
• Terry B Brasher, MPAS,PA-C
• Donald W. Breech, M.D.
• Sandra Garton Breech, M.ED., L.P.C., R.P.T
• Bonni Brennan, MS CCC/SLP
• Brett Potter DMD PLLC
• Brighter Life Solutions

• Family Nurse Practitioner in Victoria, TX
• Providers in Victoria, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.