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General NPI Number Information
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NPI Number | 1710214408
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Entity Type | Organization
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Legal Business Name | PEAR TREE MEDICAL ASSOCIATES
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Dates
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Enumeration Date | 11/17/2009
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Last Update Date | 01/08/2010
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Provider Practice Location Address
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Address Line | 6302 BROADWAY ST SUITE 130
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City | PEARLAND
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State | TX
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Zip | 77581-7856
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Country | US
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Telephone | 281-412-6700
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Fax | 281-412-6701
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Provider Business Mailing Address
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Address Line | PO BOX 84170
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City | PEARLAND
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State | TX
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Zip | 77584-0017
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Country | US
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Telephone | 281-412-6700
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Fax | 281-412-6701
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Authorized Official
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Title or Position | MD/OWNER
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Name | DR. ISABELLE F JEFFRESS
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Credential | MD
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Telephone | 281-412-6700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | K0320
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | K0320
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License Number State | TX
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