Provider Demographics
NPI:1346273026
Name:PROMECENE-COOK, PAMELA A (MD)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:A
Last Name:PROMECENE-COOK
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 1:6410 FANNIN, SUITE 250
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030
Mailing Address - Country:US
Mailing Address - Phone:832-325-7131
Mailing Address - Fax:713-512-2216
Practice Address - Street 1:6500 WEST LOOP S STE 200D
Practice Address - Street 2:
Practice Address - City:BELLAIRE
Practice Address - State:TX
Practice Address - Zip Code:77401-3535
Practice Address - Country:US
Practice Address - Phone:832-325-7131
Practice Address - Fax:713-512-2216
Is Sole Proprietor?:No
Enumeration Date:2006-07-08
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ4453207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX125467402Medicaid
TX88Y716OtherBCBS
TX125467402Medicaid
TX160039055Medicare PIN
TX88Y716Medicare PIN