MEDICARE: HAROLD J. PEAN MD

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	207R00000X	Internal Medicine Physician	J3185
2	207R00000X	Internal Medicine Physician	K2290
3	207R00000X	Internal Medicine Physician	H2104	TX

General Provider Information

NPI Number	:	1962443911
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HAROLD J. PEAN MD

Provider Business Mailing Address
First Line	:	PO BOX 1708
Second Line	:
City	:	MISSION
State	:	TX
Zip	:	78573-0030
Country	:	US
Telephone Number	:	956-519-0770
Fax Number	:	956-519-0718

Provider Business Practice Location Address
First Line	:	909 BUSINESS PARK
Second Line	:	STE 6
City	:	MISSION
State	:	TX
Zip	:	78572-6052
Country	:	US
Telephone Number	:	956-519-0770
Fax Number	:	956-519-0718

Authorized Official
Title or Position	:	MD
Name	:	DR. HAROLD J PEAN
Credential	:	MD
Telephone Number	:	956-519-0770

Provider Enumeration Date	:	06/09/2006
Last Update Date	:	03/17/2010

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