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General NPI Number Information
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NPI Number | 1639436215
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Entity Type | Individual
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Provider Name | PAMELA LIU D.M.D.
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Gender | Female
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Dates
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Enumeration Date | 04/19/2012
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Last Update Date | 06/18/2019
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Provider Practice Location Address
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Address Line | 3601 CENTER ST STE 106
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City | DEER PARK
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State | TX
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Zip | 77536-6101
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Country | US
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Telephone | 832-900-9978
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Fax |
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Provider Business Mailing Address
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Address Line | 200 S WAYSIDE DR #A
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City | HOUSTON
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State | TX
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Zip | 77011-4632
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 29031
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License Number State | TX
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