Provider Demographics
NPI:1952983272
Name:BARRAS, PAMELA DAWN (NP)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:DAWN
Last Name:BARRAS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2140 E SOUTHLAKE BLVD STE Q
Mailing Address - Street 2:
Mailing Address - City:SOUTHLAKE
Mailing Address - State:TX
Mailing Address - Zip Code:76092-6517
Mailing Address - Country:US
Mailing Address - Phone:817-895-0047
Mailing Address - Fax:
Practice Address - Street 1:2140 E SOUTHLAKE BLVD STE Q
Practice Address - Street 2:
Practice Address - City:SOUTHLAKE
Practice Address - State:TX
Practice Address - Zip Code:76092-6517
Practice Address - Country:US
Practice Address - Phone:817-895-0047
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-26
Last Update Date:2021-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXS0192207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine