Basic Information
| Provider Information | |||||||||
| NPI: | 1114112158 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | GREG WILLAIM PEARSON, MD | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | GREG WILLIAM PEARSON, MD | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 915 GESSNER RD | ||||||||
| Address2: | SUITE 860 | ||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770242527 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7134682200 | ||||||||
| FaxNumber: | 7134682213 | ||||||||
| Practice Location | |||||||||
| Address1: | 915 GESSNER RD | ||||||||
| Address2: | SUITE 860 | ||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770242527 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7134682200 | ||||||||
| FaxNumber: | 7134682213 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/12/2007 | ||||||||
| LastUpdateDate: | 06/02/2009 | ||||||||
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| AuthorizedOfficialLastName: | PEARSON | ||||||||
| AuthorizedOfficialFirstName: | GREG | ||||||||
| AuthorizedOfficialMiddleName: | WILLIAM | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 7134682200 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | MD | ||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207N00000X | L3429 | TX | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Dermatology |
No ID Information.