Provider Demographics
NPI:1336118876
Name:PEAROSE, NAHIM M (MD)
Entity Type:Individual
Prefix:DR
First Name:NAHIM
Middle Name:M
Last Name:PEAROSE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7622 LOUIS PASTEUR DR
Mailing Address - Street 2:STE 100
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-4037
Mailing Address - Country:US
Mailing Address - Phone:210-614-7840
Mailing Address - Fax:210-614-6421
Practice Address - Street 1:7622 LOUIS PASTEUR DR
Practice Address - Street 2:STE 100
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-4037
Practice Address - Country:US
Practice Address - Phone:210-614-7840
Practice Address - Fax:210-614-6421
Is Sole Proprietor?:No
Enumeration Date:2006-03-16
Last Update Date:2016-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ8084207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX121309203Medicaid
TXTXB159496OtherWELLMED MEDICARE
TX121309209OtherWELLMED MEDICAID
TX8469J2Medicare PIN
TX121309209OtherWELLMED MEDICAID