Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | 8074 | TX |
NPI | 1003812405 |
---|---|
Provider Name | Dr. Thomas William Pearson |
First Address | Houston, TX 77081-3007 |
Second Address | Houston, TX 77081-3007 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/06/2005 |
Last Update Date | 18/06/2008 |