Provider Demographics
NPI:1023551397
Name:PINNACLE NEUROMONITORING, LLC
Entity Type:Organization
Organization Name:PINNACLE NEUROMONITORING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:ALEX
Authorized Official - Middle Name:
Authorized Official - Last Name:KIMMEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-897-7494
Mailing Address - Street 1:5573 SEABURY DR
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76137-5393
Mailing Address - Country:US
Mailing Address - Phone:817-897-7494
Mailing Address - Fax:817-841-1919
Practice Address - Street 1:5573 SEABURY DR
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76137-5393
Practice Address - Country:US
Practice Address - Phone:817-897-7494
Practice Address - Fax:817-841-1919
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-18
Last Update Date:2016-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnosticGroup - Single Specialty