Provider Demographics
NPI:1013318542
Name:BERCUTT, PAMELA A (DPT)
Entity Type:Individual
Prefix:DR
First Name:PAMELA
Middle Name:A
Last Name:BERCUTT
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5252 WESTCHESTER ST
Mailing Address - Street 2:SUITE 255
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77005-4141
Mailing Address - Country:US
Mailing Address - Phone:713-360-0300
Mailing Address - Fax:713-661-6410
Practice Address - Street 1:5252 WESTCHESTER ST
Practice Address - Street 2:SUITE 255
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77005-4141
Practice Address - Country:US
Practice Address - Phone:713-360-0300
Practice Address - Fax:713-661-6410
Is Sole Proprietor?:No
Enumeration Date:2014-09-16
Last Update Date:2014-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1202510225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist