Provider Demographics
NPI:1568460855
Name:PEARCE, LAURIE L (DC)
Entity Type:Individual
Prefix:DR
First Name:LAURIE
Middle Name:L
Last Name:PEARCE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 GILMER RD.
Mailing Address - Street 2:STE. 3
Mailing Address - City:LONGVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:75604-4600
Mailing Address - Country:US
Mailing Address - Phone:903-295-2422
Mailing Address - Fax:903-757-9390
Practice Address - Street 1:123 GILMER RD.
Practice Address - Street 2:STE. 3
Practice Address - City:LONGVIEW
Practice Address - State:TX
Practice Address - Zip Code:75604-4600
Practice Address - Country:US
Practice Address - Phone:903-295-2422
Practice Address - Fax:903-757-9390
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-11
Last Update Date:2009-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX5583111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX605456OtherBLUR CROSS BLUE SHIELD
TXBLUELINK8261851OtherBCBS
TX605456OtherBLUR CROSS BLUE SHIELD
TXBLUELINK8261851OtherBCBS