Provider Demographics
NPI:1083973465
Name:PINEY POINT MEDICAL GROUP, L.L.C.
Entity Type:Organization
Organization Name:PINEY POINT MEDICAL GROUP, L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:MANN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-360-2495
Mailing Address - Street 1:PO BOX 631667
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77263-1667
Mailing Address - Country:US
Mailing Address - Phone:713-360-2495
Mailing Address - Fax:713-360-2498
Practice Address - Street 1:2500 FONDREN RD STE 301
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77063-2308
Practice Address - Country:US
Practice Address - Phone:713-360-2495
Practice Address - Fax:713-360-2498
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-04
Last Update Date:2012-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty