Healthcare Provider Details

I. General information

NPI: 1114112158
Provider Name (Legal Business Name): GREG WILLAIM PEARSON, MD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/12/2007
Last Update Date: 06/02/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

915 GESSNER RD SUITE 860
HOUSTON TX
77024-2527
US

IV. Provider business mailing address

915 GESSNER RD SUITE 860
HOUSTON TX
77024-2527
US

V. Phone/Fax

Practice location:
  • Phone: 713-468-2200
  • Fax: 713-468-2213
Mailing address:
  • Phone: 713-468-2200
  • Fax: 713-468-2213

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberL3429
License Number StateTX

VIII. Authorized Official

Name: DR. GREG WILLIAM PEARSON
Title or Position: OWNER
Credential: MD
Phone: 713-468-2200