Individual
PAMELA J MAINOUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6100 HARRIS PKWY, FORT WORTH, TX 76132-4101
(817) 346-5000
Mailing address
1169 N BURLESON BLVD # 107-233, BURLESON, TX 76028-7011
(817) 269-1472
(817) 531-2939
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
94494
CO
Other
Enumeration date
07/25/2017
Last updated
07/25/2017
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