Provider Demographics
NPI:1427225952
Name:GURNEY F PEARSALL SR MD PA
Entity Type:Organization
Organization Name:GURNEY F PEARSALL SR MD PA
Other - Org Name:PEARSALL PEDIATRICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GURNEY
Authorized Official - Middle Name:
Authorized Official - Last Name:PEARSALL
Authorized Official - Suffix:SR
Authorized Official - Credentials:MD
Authorized Official - Phone:713-790-9265
Mailing Address - Street 1:7900 FANNIN ST
Mailing Address - Street 2:SUITE 3200
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054-2934
Mailing Address - Country:US
Mailing Address - Phone:713-790-9265
Mailing Address - Fax:713-790-1006
Practice Address - Street 1:2010 NAOMI ST STE C
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-3837
Practice Address - Country:US
Practice Address - Phone:713-790-9265
Practice Address - Fax:713-790-1006
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-14
Last Update Date:2023-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD3518208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX84Z311OtherBLUE CROSS & BLUE SHIELD OF TEXAS
TX145015701Medicaid