Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | M0199 | TX |
N | 207QS0010X | Family Doctor - Sports Medicine | M0199 | TX |
NPI | 1265413256 |
---|---|
Provider Name | Pamela C Oconnor |
First Address | The Woodlands, TX 77384-4000 |
Second Address | The Woodlands, TX 77384-4000 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/11/2005 |
Last Update Date | 26/10/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H03171 | (02) |