Organization
PAMELA B. GROSSMAN, PH.D.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PAMELA B. GROSSMAN PH.D. (OWNER/PSYCHOLOGIST)
(979) 268-7776
Entity
Organization
Contact information
Practice address
3201 UNIVERSITY DR E, SUITE 200, BRYAN, TX 77802-3475
(979) 268-7776
(979) 268-8618
Mailing address
3201 UNIVERSITY DR E, SUITE 200, BRYAN, TX 77802-3475
(979) 268-7776
(979) 268-8618
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
25064
TX
Other
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
Enumeration date
05/14/2008
Last updated
05/14/2008
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