Provider Demographics
NPI:1023027448
Name:PINKERMAN, JOHN EDWARD (PHD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:EDWARD
Last Name:PINKERMAN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:413 E RAILROAD AVE
Mailing Address - Street 2:
Mailing Address - City:PORT ISABEL
Mailing Address - State:TX
Mailing Address - Zip Code:78578-4108
Mailing Address - Country:US
Mailing Address - Phone:956-994-3880
Mailing Address - Fax:956-994-3877
Practice Address - Street 1:2529 W TRENTON RD
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-5070
Practice Address - Country:US
Practice Address - Phone:956-994-3880
Practice Address - Fax:956-994-3877
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-05
Last Update Date:2016-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX25251103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX113425603Medicaid
TX82619PMedicare ID - Type Unspecified