Provider Demographics
NPI:1891478491
Name:DURHAM, PAMELA S
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:S
Last Name:DURHAM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18826 BRESCIA LN
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77449-1916
Mailing Address - Country:US
Mailing Address - Phone:713-624-2010
Mailing Address - Fax:832-674-7022
Practice Address - Street 1:18826 BRESCIA LN
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77449-1916
Practice Address - Country:US
Practice Address - Phone:713-624-2010
Practice Address - Fax:832-674-7022
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-09
Last Update Date:2023-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
253Z00000X
TX85-4323424253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care