Basic Information
| Provider Information | |||||||||
| NPI: | 1740811348 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PEARSON | ||||||||
| FirstName: | CATHERINE | ||||||||
| MiddleName: | CELESTE | ||||||||
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| Credential: | APRN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 701 ARKANSAS BLVD | ||||||||
| Address2: | |||||||||
| City: | TEXARKANA | ||||||||
| State: | AR | ||||||||
| PostalCode: | 718542105 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8797725028 | ||||||||
| FaxNumber: | 8707722138 | ||||||||
| Practice Location | |||||||||
| Address1: | 701 ARKANSAS BLVD | ||||||||
| Address2: | |||||||||
| City: | TEXARKANA | ||||||||
| State: | AR | ||||||||
| PostalCode: | 718542105 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8707725028 | ||||||||
| FaxNumber: | 8707722138 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/01/2020 | ||||||||
| LastUpdateDate: | 04/16/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/16/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0800X | 123786 | AR | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry |
No ID Information.