Provider Demographics
NPI:1114112158
Name:GREG WILLAIM PEARSON, MD
Entity Type:Organization
Organization Name:GREG WILLAIM PEARSON, MD
Other - Org Name:GREG WILLIAM PEARSON, MD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GREG
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:PEARSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-468-2200
Mailing Address - Street 1:915 GESSNER RD
Mailing Address - Street 2:SUITE 860
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-2527
Mailing Address - Country:US
Mailing Address - Phone:713-468-2200
Mailing Address - Fax:713-468-2213
Practice Address - Street 1:915 GESSNER RD
Practice Address - Street 2:SUITE 860
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-2527
Practice Address - Country:US
Practice Address - Phone:713-468-2200
Practice Address - Fax:713-468-2213
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-12
Last Update Date:2009-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL3429207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00894ZMedicare PIN