Provider Demographics
NPI:1962149476
Name:MARKS, PAMELA ANN (LVN)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:ANN
Last Name:MARKS
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:PAMELA
Other - Middle Name:ANN
Other - Last Name:ODUMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:505 N SAM HOUSTON PKWY E STE 170C
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77060-4121
Mailing Address - Country:US
Mailing Address - Phone:346-571-5594
Mailing Address - Fax:
Practice Address - Street 1:505 N SAM HOUSTON PKWY E STE 170C
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77060-4121
Practice Address - Country:US
Practice Address - Phone:346-571-5594
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-16
Last Update Date:2022-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX160408164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse