MEDICARE: MS. PAMELA BYLER DYER LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	005241	TX

General Provider Information

NPI Number	:	1629258900
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. PAMELA BYLER DYER LCSW

Provider Business Mailing Address
First Line	:	3522 SUNSET BLVD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77005-2134
Country	:	US
Telephone Number	:	713-661-6873
Fax Number	:	713-661-7717

Provider Business Practice Location Address
First Line	:	3522 SUNSET BLVD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77005-2134
Country	:	US
Telephone Number	:	713-661-6873
Fax Number	:	713-661-7717

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/05/2007
Last Update Date	:	11/05/2007

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