Provider Demographics
NPI:1104994730
Name:PEARSALL, GURNEY FIELDS SR (MD,FAAP)
Entity type:Individual
Prefix:DR
First Name:GURNEY
Middle Name:FIELDS
Last Name:PEARSALL
Suffix:SR
Gender:M
Credentials:MD,FAAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3003 S LOOP W STE 410
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054-1383
Mailing Address - Country:US
Mailing Address - Phone:713-790-9265
Mailing Address - Fax:713-790-1006
Practice Address - Street 1:3003 S LOOP W STE 410
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-1383
Practice Address - Country:US
Practice Address - Phone:713-790-9265
Practice Address - Fax:713-790-1006
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-01
Last Update Date:2024-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD3518208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX121514702Medicaid
TX121514701Medicaid
TX145015701Medicaid
TX25284OtherAMERIGROUP
TX84Z311OtherBLU CROSS & BLUE SHEILD
TX121514703Medicaid
TX121514705Medicaid
TX121514705Medicaid