Healthcare Provider Details

I. General information

NPI: 1750662136
Provider Name (Legal Business Name): MEGAN PEARCE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/30/2011
Last Update Date: 01/11/2021
Certification Date: 01/11/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18780 INTERSTATE 20
CANTON TX
75103-3593
US

IV. Provider business mailing address

6451 BRENTWOOD STAIR RD SUITE 200
FORT WORTH TX
76112-3200
US

V. Phone/Fax

Practice location:
  • Phone: 903-567-7748
  • Fax: 903-606-4905
Mailing address:
  • Phone: 817-496-9700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberQ2180
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberAW3068978-3024
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: