Provider Demographics
NPI:1063848745
Name:PINNACLES HCCS INC
Entity Type:Organization
Organization Name:PINNACLES HCCS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:WESLYN
Authorized Official - Middle Name:W
Authorized Official - Last Name:CARTER
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:281-741-5265
Mailing Address - Street 1:440 BENMAR DR
Mailing Address - Street 2:SUITE #1175
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77060-3165
Mailing Address - Country:US
Mailing Address - Phone:281-741-5265
Mailing Address - Fax:281-741-5307
Practice Address - Street 1:440 BENMAR DR
Practice Address - Street 2:SUITE #1175
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77060-3165
Practice Address - Country:US
Practice Address - Phone:281-741-5265
Practice Address - Fax:281-741-5307
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-25
Last Update Date:2013-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXTXHMLMedicaid
TXHCSMedicaid