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General NPI Number Information
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NPI Number | 1336118876
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Entity Type | Individual
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Provider Name | NAHIM M. PEAROSE M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/16/2006
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Last Update Date | 10/09/2024
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Provider Practice Location Address
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Address Line | 4647 MEDICAL DR
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City | SAN ANTONIO
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State | TX
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Zip | 78229-4403
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Country | US
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Telephone | 210-358-8145
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Fax | 210-358-8536
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Provider Business Mailing Address
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Address Line | 903 W MARTIN ST # MS 49-2
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City | SAN ANTONIO
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State | TX
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Zip | 78207-0903
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Country | US
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Telephone | 210-358-0572
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Fax | 210-358-5940
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | J8084
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License Number State | TX
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