Provider Demographics
NPI:1235544610
Name:PINNACLE LABORATORIES
Entity Type:Organization
Organization Name:PINNACLE LABORATORIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:M
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-391-8505
Mailing Address - Street 1:1355 W GRAY ST
Mailing Address - Street 2:STE B
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77019-4019
Mailing Address - Country:US
Mailing Address - Phone:713-391-8505
Mailing Address - Fax:
Practice Address - Street 1:1605 AIRPORT FWY STE 200
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:TX
Practice Address - Zip Code:76021-5730
Practice Address - Country:US
Practice Address - Phone:817-685-4263
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SURGEONS PRACTICE SOLUTIONS, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-06-24
Last Update Date:2014-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory