Provider Demographics
NPI:1013950484
Name:PEAN, HAROLD J (MD)
Entity Type:Individual
Prefix:DR
First Name:HAROLD
Middle Name:J
Last Name:PEAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1708
Mailing Address - Street 2:
Mailing Address - City:MISSION
Mailing Address - State:TX
Mailing Address - Zip Code:78573-0030
Mailing Address - Country:US
Mailing Address - Phone:956-519-0770
Mailing Address - Fax:956-519-0718
Practice Address - Street 1:909 BUSINESS PARK DR STE 6
Practice Address - Street 2:
Practice Address - City:MISSION
Practice Address - State:TX
Practice Address - Zip Code:78572-6054
Practice Address - Country:US
Practice Address - Phone:956-519-0770
Practice Address - Fax:956-519-0718
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2021-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ3185207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
F17663Medicare UPIN
TX89270BMedicare PIN