MEDICARE: STACEY B. PEARLMAN PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant
2	363AM0700X	Medical Physician Assistant	1790	MA
3	363A00000X	Physician Assistant	PA03099	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1770544199
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STACEY B. PEARLMAN PA

Provider Business Mailing Address
First Line	:	7401 ROUND HILL RD
Second Line	:
City	:	MCKINNEY
State	:	TX
Zip	:	75072-5747
Country	:	US
Telephone Number	:	972-832-7440
Fax Number	:

Provider Business Practice Location Address
First Line	:	7401 ROUND HILL RD
Second Line	:
City	:	MCKINNEY
State	:	TX
Zip	:	75072-5747
Country	:	US
Telephone Number	:	972-832-7440
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/28/2006
Last Update Date	:	11/29/2024

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Directions to “ STACEY B. PEARLMAN PA” Practice Location

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