Individual
PAMELA M. HENRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
5201 HARRY HINES BLVD, WISH TUBAL CLINIC, DALLAS, TX 75235-7708
(214) 590-5306
(214) 590-2798
Mailing address
PO BOX 660599, DALLAS, TX 75266-0599
Taxonomy
Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
Primary
623628
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036913401
—
TX
05
—
036913402
—
TX
01
—
8Y2139
BLUE CROSS BLUE SHIELD
TX
Enumeration date
12/29/2006
Last updated
06/16/2009
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