Provider Demographics
NPI:1831120344
Name:PIERCE, JESSICA LENORE (MD)
Entity Type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:LENORE
Last Name:PIERCE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:LENORE
Other - Last Name:FALER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:16620 N US HIGHWAY 281 STE 300
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78232-2679
Mailing Address - Country:US
Mailing Address - Phone:210-614-1231
Mailing Address - Fax:210-499-0811
Practice Address - Street 1:4458 MEDICAL DR STE 205
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-3748
Practice Address - Country:US
Practice Address - Phone:210-614-1515
Practice Address - Fax:210-615-6904
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM2751207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX184799803Medicaid
TX8F9388OtherBC BS OF TEXAS
TX8J9667Medicare PIN
TX8F9388OtherBC BS OF TEXAS