MEDICARE: JOHN R PIERCE JR LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies
2	335E00000X	Prosthetic/Orthotic Supplier

General Provider Information

NPI Number	:	1073460887
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOHN R PIERCE JR LLC

Provider Business Mailing Address
First Line	:	1318 MEMORIAL DR STE 201
Second Line	:
City	:	BRYAN
State	:	TX
Zip	:	77802-5215
Country	:	US
Telephone Number	:	409-949-4100
Fax Number	:	281-957-9757

Provider Business Practice Location Address
First Line	:	471 E 1000 S STE D
Second Line	:
City	:	PLEASANT GROVE
State	:	UT
Zip	:	84062-3694
Country	:	US
Telephone Number	:	409-949-4100
Fax Number	:	281-957-9757

Authorized Official
Title or Position	:	OWNER
Name	:	DAVID PATTERSON
Credential	:
Telephone Number	:	385-215-9985

Provider Enumeration Date	:	03/11/2026
Last Update Date	:	03/11/2026

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