Healthcare Provider Details

I. General information

NPI: 1588975189
Provider Name (Legal Business Name): PAM MESKER PIERCE LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2010
Last Update Date: 06/29/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8222 DOUGLAS AVE STE. 375
DALLAS TX
75225-5923
US

IV. Provider business mailing address

10321 VAN DYKE RD
DALLAS TX
75218-1002
US

V. Phone/Fax

Practice location:
  • Phone: 214-905-5090
  • Fax: 214-905-1998
Mailing address:
  • Phone: 214-342-0070
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number24651
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: