Healthcare Provider Details

I. General information

NPI: 1003468059
Provider Name (Legal Business Name): PAMELA ANNE ROGERS MA, LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: PAMELA POWELL

II. Dates (important events)

Enumeration Date: 07/10/2019
Last Update Date: 07/10/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13333 DOTSON RD STE 160
HOUSTON TX
77070-4305
US

IV. Provider business mailing address

13333 DOTSON RD STE 160
HOUSTON TX
77070-4305
US

V. Phone/Fax

Practice location:
  • Phone: 346-206-3992
  • Fax: 832-652-3626
Mailing address:
  • Phone: 346-206-3992
  • Fax: 832-652-3626

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number9453
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: