Provider Demographics
NPI:1265413256
Name:OCONNOR, PAMELA C (MD)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:C
Last Name:OCONNOR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:PAMELA
Other - Middle Name:C
Other - Last Name:HESTON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3115 COLLEGE PARK DR
Mailing Address - Street 2:SUITE 106
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77384-4000
Mailing Address - Country:US
Mailing Address - Phone:936-271-2555
Mailing Address - Fax:936-271-2557
Practice Address - Street 1:3115 COLLEGE PARK DR
Practice Address - Street 2:SUITE 106
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77384-4000
Practice Address - Country:US
Practice Address - Phone:936-271-2555
Practice Address - Fax:936-271-2557
Is Sole Proprietor?:No
Enumeration Date:2005-11-08
Last Update Date:2012-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM0199207Q00000X, 207QS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
H03171Medicare UPIN
TX8E0128Medicare ID - Type Unspecified