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General NPI Number Information
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NPI Number | 1821314576
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Entity Type | Individual
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Provider Name | LINDA TIFFANY PEARSON M.D.
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Gender | Female
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Dates
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Enumeration Date | 04/19/2010
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Last Update Date | 09/16/2021
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Provider Practice Location Address
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Address Line | 17189 INTERSTATE 45 S STE 675
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City | SHENANDOAH
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State | TX
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Zip | 77385-3320
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Country | US
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Telephone | 936-270-3900
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Fax |
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Provider Business Mailing Address
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Address Line | 17189 INTERSTATE 45 S STE 675
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City | SHENANDOAH
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State | TX
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Zip | 77385-3320
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Country | US
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Telephone | 936-270-3900
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Fax |
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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 | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | MD0000051113
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | S4667
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License Number State | TX
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