Organization Active NPI

Pearl Healthcare, LLC

  • Gerontology Nurse Practitioner
  • Houston, TX
National Provider Identifier
1992291462
Registry record updated Mar 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
AP118306 Issued in TX
Legal business name
PEARL HEALTHCARE, LLC
Practice address
3733 Westheimer Rd Ste 1-559
Houston, TX 77027-5271
Phone
(713) 955-7374
Fax
(702) 537-0985
NPI assigned
Jul 7, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Alero Obianyor Waterhouse, GNP-BC
Title
Director
Phone
(832) 722-1618

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X
Gerontology Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LG0600X AP118306 TX Primary

Addresses

Primary practice location

3733 Westheimer Rd Ste 1-559
Houston, TX 77027-5271

Mailing address

3733 Westheimer Rd Ste 1-559
Houston, TX 77027-5271
Phone (713) 955-7374

Other identifiers 1

IdentifierTypeStateIssuer
3919383MedicaidTX

National Provider Directory

National Provider Directory

Locations

3733 Westheimer Rd
Ste 1559
Houston, TX 77027
Phone (713) 955-7374

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1530921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1552521600000",
    "number": "1992291462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3733 WESTHEIMER RD STE 1-559",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770275271",
            "telephone_number": "713-955-7374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3733 WESTHEIMER RD STE 1-559",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770275271",
            "telephone_number": "713-955-7374",
            "fax_number": "702-537-0985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEARL HEALTHCARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-07",
        "last_updated": "2019-03-14",
        "status": "A",
        "authorized_official_last_name": "WATERHOUSE",
        "authorized_official_first_name": "ALERO",
        "authorized_official_middle_name": "OBIANYOR",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "832-722-1618",
        "authorized_official_credential": "GNP-BC"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "TX",
            "license": "AP118306",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3919383",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.