Provider Demographics
NPI:1003994328
Name:FLINT, PAMELA J (PHD)
Entity Type:Individual
Prefix:DR
First Name:PAMELA
Middle Name:J
Last Name:FLINT
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16800 DALLAS PARKWAY
Mailing Address - Street 2:STE 150
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75248
Mailing Address - Country:US
Mailing Address - Phone:972-733-7242
Mailing Address - Fax:972-733-7257
Practice Address - Street 1:16800 DALLAS PARKWAY
Practice Address - Street 2:STE 150
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75248
Practice Address - Country:US
Practice Address - Phone:972-733-7242
Practice Address - Fax:972-733-7257
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX30908103T00000X
TX240240163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist
Not Answered163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8D5394Medicare ID - Type Unspecified