Provider Demographics
NPI:1073500070
Name:PINNACLE SPORTSCARE, LLP
Entity Type:Organization
Organization Name:PINNACLE SPORTSCARE, LLP
Other - Org Name:PINNACLE PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:
Authorized Official - Last Name:RETTKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-529-3691
Mailing Address - Street 1:5100 W ELDORADO PKWY
Mailing Address - Street 2:#102-20PPT
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75070-6309
Mailing Address - Country:US
Mailing Address - Phone:817-310-3737
Mailing Address - Fax:817-310-3736
Practice Address - Street 1:2303 IRA E WOODS AVE
Practice Address - Street 2:BUILDING B
Practice Address - City:GRAPEVINE
Practice Address - State:TX
Practice Address - Zip Code:76051-3926
Practice Address - Country:US
Practice Address - Phone:817-310-3737
Practice Address - Fax:817-310-3736
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-04
Last Update Date:2008-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0092KMOtherBCBS
TX0092KMOtherBCBS