Healthcare Provider Details

I. General information

NPI: 1073460887
Provider Name (Legal Business Name): JOHN R PIERCE JR LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/11/2026
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1318 MEMORIAL DR STE 201
BRYAN TX
77802-5215
US

IV. Provider business mailing address

471 E 1000 S STE D
PLEASANT GROVE UT
84062-3694
US

V. Phone/Fax

Practice location:
  • Phone: 409-949-4100
  • Fax: 281-957-9757
Mailing address:
  • Phone: 409-949-4100
  • Fax: 281-957-9757

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

Name: ALICIA HERMOSILLO
Title or Position: MANAGER
Credential:
Phone: 855-407-1227