MEDICARE: PAMELA HOLDER M.D.

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	207ZC0500X	Cytopathology Physician	F9570	TX
2	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	F9570	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	220015065	OTHER	TX	RAILROAD MEDICARE

General Provider Information

NPI Number	:	1912904319
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAMELA HOLDER M.D.

Provider Business Mailing Address
First Line	:	PO BOX 421849
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77242-1849
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8076 EL RIO ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77054-4186
Country	:	US
Telephone Number	:	713-481-3536
Fax Number	:	713-432-0221

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

Provider Enumeration Date	:	06/30/2005
Last Update Date	:	03/19/2009

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