Provider Demographics
NPI:1558685099
Name:PAMELA D WILSON MD PA
Entity Type:Organization
Organization Name:PAMELA D WILSON MD PA
Other - Org Name:GLOBAL ANESTHESIA SERVICES, PA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:D
Authorized Official - Last Name:WILSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-569-9999
Mailing Address - Street 1:5535 MEMORIAL DR
Mailing Address - Street 2:SUITE F104
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77007-8021
Mailing Address - Country:US
Mailing Address - Phone:713-429-5919
Mailing Address - Fax:
Practice Address - Street 1:25440 INTERSTATE 45
Practice Address - Street 2:STE 200
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77386-1343
Practice Address - Country:US
Practice Address - Phone:713-429-5919
Practice Address - Fax:866-541-2559
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-25
Last Update Date:2011-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ8842208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0020PXOtherBLUE CROSS BLUE SHIELD TEXAS
TXG22063Medicare UPIN
TX0020PXOtherBLUE CROSS BLUE SHIELD TEXAS