Provider Demographics
NPI:1578522397
Name:PEARSALL, MARINA M (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:MARINA
Middle Name:M
Last Name:PEARSALL
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5349 VAL VERDE ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77056-6220
Mailing Address - Country:US
Mailing Address - Phone:713-622-4127
Mailing Address - Fax:713-787-6401
Practice Address - Street 1:2951 CHIMNEY ROCK RD
Practice Address - Street 2:SUITE A
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77056-5924
Practice Address - Country:US
Practice Address - Phone:713-522-4037
Practice Address - Fax:713-787-6401
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK4523207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8R7610OtherBCBS
TXG26646Medicare UPIN
TX00733DMedicare ID - Type Unspecified