1750506788 NPI number — DAVID E. PEARCE M.D.,P.A.

Table of content: (NPI 1750506788)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1750506788 NPI number — DAVID E. PEARCE M.D.,P.A.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DAVID E. PEARCE M.D.,P.A.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
DAVID E. PEARCE M.D., P.A.
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1750506788
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/31/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
12/07/2007
NPI Reactivation Date:
12/31/2007

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5920 SARATOGA BLVD STE 350
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CORPUS CHRISTI
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78414-4105
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
361-991-1290
Provider Business Mailing Address Fax Number:
361-991-1292

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5920 SARATOGA BLVD
Provider Second Line Business Practice Location Address:
SUITE 350
Provider Business Practice Location Address City Name:
CORPUS CHRISTI
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78414-4103
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
361-991-1290
Provider Business Practice Location Address Fax Number:
361-991-1292
Provider Enumeration Date:
04/16/2007

Additional Information

Authorized Official

Authorized Official Last Name:
PEARCE
Authorized Official First Name:
DAVID
Authorized Official Middle Name:
EARL
Authorized Official Title or Position:
PHYSICIAN
Authorized Official Telephone Number:
361-991-1290

Provider Taxonomy Codes

  • Taxonomy code: 208600000X , with the licence number:  G9510 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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