Provider Demographics
NPI:1982695037
Name:DUGANO - DAPHNIS, PAMELA D (MD)
Entity type:Individual
Prefix:MS
First Name:PAMELA
Middle Name:D
Last Name:DUGANO - DAPHNIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MRS
Other - First Name:PAMELA
Other - Middle Name:DENISE
Other - Last Name:DUGANO-DAPHNIS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:333 N. TEXAS AVE
Mailing Address - Street 2:STE 4100
Mailing Address - City:WEBSTER
Mailing Address - State:TX
Mailing Address - Zip Code:77598
Mailing Address - Country:US
Mailing Address - Phone:832-984-6549
Mailing Address - Fax:281-338-7755
Practice Address - Street 1:333 N TEXAS AVE
Practice Address - Street 2:STE 4100
Practice Address - City:WEBSTER
Practice Address - State:TX
Practice Address - Zip Code:77598
Practice Address - Country:US
Practice Address - Phone:832-984-6549
Practice Address - Fax:281-338-7755
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-28
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK5285207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX27-0876011OtherTX ID
TX8CD832OtherBCBS IND
TXH28898Medicare UPIN