Individual provider Active NPI

Pamela Horton, PHD

  • Clinical Psychologist
  • Georgetown, TX
National Provider Identifier
1811967581
Registry record updated Sep 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
2-5250 Issued in TX
Practice address
1618 Williams Dr
Suite 6
Georgetown, TX 78628-3660
Phone
(512) 931-2162
NPI assigned
Jan 25, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 18, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PS009206L PA
Clinical Psychologist 103TC0700X 2-5250 TX Primary

Addresses

Primary practice location

1618 Williams Dr
Suite 6
Georgetown, TX 78628-3660

Mailing address

PO Box 1087
Georgetown, TX 78627-1087
Phone (512) 931-2162

Other identifiers 1

IdentifierTypeStateIssuer
0360430-01MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.
Opted out of Medicare
Yes, effective Apr 1, 2017 through Apr 1, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PS009206LPAMDClinical Psychologist
2-5250TXMDClinical Psychologist

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1138147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1221696000000",
    "number": "1811967581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1087",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "786271087",
            "telephone_number": "512-931-2162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1618 WILLIAMS DR",
            "address_2": "SUITE 6",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "786283660",
            "telephone_number": "512-931-2162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HORTON",
        "first_name": "PAMELA",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-01-25",
        "last_updated": "2008-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PA",
            "license": "PS009206L",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": "2-5250",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0360430-01",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Georgetown, TX

Sources for this page

Verify at the official NPI Registry.