Provider Demographics
NPI:1235351065
Name:CARR, PAMELA MARGARET (MD)
Entity Type:Individual
Prefix:DR
First Name:PAMELA
Middle Name:MARGARET
Last Name:CARR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4610 LEA LN
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77469-9700
Mailing Address - Country:US
Mailing Address - Phone:281-494-0034
Mailing Address - Fax:281-494-0066
Practice Address - Street 1:1111 HIGHWAY 6 STE 160
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-4900
Practice Address - Country:US
Practice Address - Phone:281-494-0034
Practice Address - Fax:281-494-0066
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-02
Last Update Date:2007-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF-1433207N00000X, 207NS0135X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural Dermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXC14221Medicare UPIN