Healthcare Provider Details

I. General information

NPI: 1811209075
Provider Name (Legal Business Name): RANDY RIC PEARCE D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/05/2010
Last Update Date: 02/20/2025
Certification Date: 02/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3315 S ALAMEDA ST
CORPUS CHRISTI TX
78411-1820
US

IV. Provider business mailing address

1521 S STAPLES ST STE 606
CORPUS CHRISTI TX
78404-3166
US

V. Phone/Fax

Practice location:
  • Phone: 877-832-2652
  • Fax: 361-371-8376
Mailing address:
  • Phone: 361-884-2904
  • Fax: 361-371-8376

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberOT013745
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberR3936
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: