Provider Demographics
NPI:1447380761
Name:GREENLEE, JANET WALTERS (PA-C)
Entity type:Individual
Prefix:MRS
First Name:JANET
Middle Name:WALTERS
Last Name:GREENLEE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:13114 YOUNGFIELD DR
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77429-3813
Mailing Address - Country:US
Mailing Address - Phone:713-254-9097
Mailing Address - Fax:281-320-1072
Practice Address - Street 1:13300 HARGRAVE RD
Practice Address - Street 2:#505
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77070-4373
Practice Address - Country:US
Practice Address - Phone:281-894-0177
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA01129363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical