Provider Demographics
NPI:1881966729
Name:WILHITE, PAMELA EVONNE
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:EVONNE
Last Name:WILHITE
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 1:2000 CRAWFORD ST STE 100
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77002-9090
Mailing Address - Country:US
Mailing Address - Phone:713-659-2020
Mailing Address - Fax:713-759-2020
Practice Address - Street 1:2000 CRAWFORD ST STE 100
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77002-9090
Practice Address - Country:US
Practice Address - Phone:713-659-2020
Practice Address - Fax:713-759-2020
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-08
Last Update Date:2022-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX136705156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX6599940002OtherMEDICARE NSC