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General NPI Number Information
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NPI Number | 1992291462
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Entity Type | Organization
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Legal Business Name | PEARL HEALTHCARE, LLC
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Dates
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Enumeration Date | 07/07/2018
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Last Update Date | 03/14/2019
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Provider Practice Location Address
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Address Line | 3733 WESTHEIMER RD STE 1-559
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City | HOUSTON
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State | TX
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Zip | 77027-5271
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Country | US
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Telephone | 713-955-7374
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Fax | 702-537-0985
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Provider Business Mailing Address
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Address Line | 3733 WESTHEIMER RD STE 1-559
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City | HOUSTON
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State | TX
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Zip | 77027-5271
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Country | US
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Telephone | 713-955-7374
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | ALERO OBIANYOR WATERHOUSE
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Credential | GNP-BC
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Telephone | 832-722-1618
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | AP118306
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License Number State | TX
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