Provider Demographics
NPI:1851595607
Name:PEARCE, JALANE CECELIA (DO)
Entity Type:Individual
Prefix:DR
First Name:JALANE
Middle Name:CECELIA
Last Name:PEARCE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8743 SHADY GATE
Mailing Address - Street 2:
Mailing Address - City:FAIR OAKS RANCH
Mailing Address - State:TX
Mailing Address - Zip Code:78015-2204
Mailing Address - Country:US
Mailing Address - Phone:215-510-4841
Mailing Address - Fax:
Practice Address - Street 1:8743 SHADY GATE
Practice Address - Street 2:
Practice Address - City:FAIR OAKS RANCH
Practice Address - State:TX
Practice Address - Zip Code:78015-2204
Practice Address - Country:US
Practice Address - Phone:215-510-4841
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-14
Last Update Date:2023-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC32274208000000X
NC00123208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics