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General NPI Number Information
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NPI Number | 1407939861
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Entity Type | Individual
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Provider Name | WALTER STEPHEN PEARSON SR. RPH- PHARMACIST
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Gender | Male
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Dates
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Enumeration Date | 10/21/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 101 E WASHINGTON ST
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City | HOUSTON
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State | MS
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Zip | 38851-2225
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Country | US
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Telephone | 662-456-2551
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Fax | 662-456-3020
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Provider Business Mailing Address
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Address Line | PO BOX 509
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City | HOUSTON
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State | MS
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Zip | 38851-0509
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Country | US
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Telephone | 662-456-2551
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Fax | 662-456-3020
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | E6515
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License Number State | MS
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