Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | Q6085 | TX |
N | 2081P2900X | Pain Medicine | Q6085 | TX |
NPI | 1003109091 |
---|---|
Provider Name | Dr. Stephanie Naomi Pearson |
First Address | San Antonio, TX 78240-1598 |
Second Address | San Antonio, TX 78240-1598 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/05/2011 |
Last Update Date | 26/08/2019 |