Provider Demographics
NPI:1750506788
Name:DAVID E. PEARCE M.D.,P.A.
Entity Type:Organization
Organization Name:DAVID E. PEARCE M.D.,P.A.
Other - Org Name:DAVID E. PEARCE M.D., P.A.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:EARL
Authorized Official - Last Name:PEARCE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:361-991-1290
Mailing Address - Street 1:5920 SARATOGA BLVD STE 350
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78414-4105
Mailing Address - Country:US
Mailing Address - Phone:361-991-1290
Mailing Address - Fax:361-991-1292
Practice Address - Street 1:5920 SARATOGA BLVD
Practice Address - Street 2:SUITE 350
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78414-4103
Practice Address - Country:US
Practice Address - Phone:361-991-1290
Practice Address - Fax:361-991-1292
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-16
Last Update Date:2007-12-31
Deactivation Date:2007-12-07
Deactivation Code:
Reactivation Date:2007-12-31
Provider Licenses
StateLicense IDTaxonomies
TXG9510208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00GS12Medicare PIN
TNC20346Medicare UPIN
TN00GS12Medicare ID - Type UnspecifiedMEDICARE