Provider Demographics
NPI:1174609549
Name:PIERCE, JOE DAVID (CRNA)
Entity type:Individual
Prefix:MR
First Name:JOE
Middle Name:DAVID
Last Name:PIERCE
Suffix:
Gender:M
Credentials:CRNA
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Other - First Name:
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Mailing Address - Street 1:7210 PHARAOH DR
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78412-3827
Mailing Address - Country:US
Mailing Address - Phone:361-985-9980
Mailing Address - Fax:361-985-9980
Practice Address - Street 1:7210 PHARAOH DR
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78412-3827
Practice Address - Country:US
Practice Address - Phone:361-985-9980
Practice Address - Fax:361-985-9980
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX249047367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered