Provider Demographics
NPI:1225038409
Name:SINGLETARY, PAMELA RENE (DDS)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:RENE
Last Name:SINGLETARY
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3401 EL SALIDO PKWY
Mailing Address - Street 2:
Mailing Address - City:CEDAR PARK
Mailing Address - State:TX
Mailing Address - Zip Code:78613
Mailing Address - Country:US
Mailing Address - Phone:512-401-8888
Mailing Address - Fax:512-401-8887
Practice Address - Street 1:3401 EL SALIDO PKWY
Practice Address - Street 2:
Practice Address - City:CEDAR PARK
Practice Address - State:TX
Practice Address - Zip Code:78613
Practice Address - Country:US
Practice Address - Phone:512-401-8888
Practice Address - Fax:512-401-8887
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-28
Last Update Date:2012-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX178091223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
460285OtherUNITED CONCORDIA
TX111209603Medicaid
TX86D859OtherBCBS