Provider Demographics
NPI:1508891961
Name:BERENS, PAMELA D (MD)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:D
Last Name:BERENS
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 1:6431 FANNIN
Mailing Address - Street 2:MSB 3.286
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030
Mailing Address - Country:US
Mailing Address - Phone:713-500-6471
Mailing Address - Fax:713-500-0508
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:713-486-9300
Practice Address - Fax:713-486-9301
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2024-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ4714207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX88Y700OtherBCBS
TX129823401OtherCSHCN
TX129823402Medicaid
TX129823401OtherCSHCN
TX88Y700OtherBCBS
TXF64225Medicare UPIN