# PAMELA B. GROSSMAN, PH.D.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1649447053
- **Authorized official:** DR. PAMELA B. GROSSMAN PH.D. (OWNER/PSYCHOLOGIST)
- **Authorized official phone:** (979) 268-7776

## Contact information

- **Practice address:** 3201 UNIVERSITY DR E, SUITE 200, BRYAN, TX 77802-3475
- **Practice address phone:** (979) 268-7776
- **Practice address fax:** (979) 268-8618
- **Mailing address:** 3201 UNIVERSITY DR E, SUITE 200, BRYAN, TX 77802-3475
- **Mailing address phone:** (979) 268-7776
- **Mailing address fax:** (979) 268-8618

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 103TC2200X | Clinical Child & Adolescent Psychologist | 25064 | TX | Yes |

## Other

- **Enumeration date:** 05/14/2008
- **Last updated:** 05/14/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0031JK | BC/BS | TX |
| 05 | — | 036303801 | — | TX |
| 05 | — | 152784801 | — | TX |
| 01 | — | 86740A | BC/BS | TX |
| 01 | — | U41F | BC/BS | TX |