Provider Demographics
NPI:1073792743
Name:DANIEL B PEARSON III MD PA
Entity Type:Organization
Organization Name:DANIEL B PEARSON III MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:B
Authorized Official - Last Name:PEARSON
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:214-943-1310
Mailing Address - Street 1:302 W 9TH ST
Mailing Address - Street 2:SUITE D
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:73208-4834
Mailing Address - Country:US
Mailing Address - Phone:214-943-1310
Mailing Address - Fax:
Practice Address - Street 1:302 W 9TH ST
Practice Address - Street 2:SUITE D
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:73208-4834
Practice Address - Country:US
Practice Address - Phone:214-943-1310
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-30
Last Update Date:2007-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH07182084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty