Provider Demographics
NPI:1790456143
Name:PEARSON, R L (NTP)
Entity Type:Individual
Prefix:
First Name:R L
Middle Name:
Last Name:PEARSON
Suffix:
Gender:F
Credentials:NTP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19401 STATE HIGHWAY 249 APT 638
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77070-3036
Mailing Address - Country:US
Mailing Address - Phone:832-392-9799
Mailing Address - Fax:
Practice Address - Street 1:15510 CYPRESS GARDEN DR STE C
Practice Address - Street 2:
Practice Address - City:TOMBALL
Practice Address - State:TX
Practice Address - Zip Code:77377-6307
Practice Address - Country:US
Practice Address - Phone:832-392-9979
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-24
Last Update Date:2022-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX820133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist