Provider Demographics
NPI:1457657314
Name:PINNACLE SPORTS PERFORMANCE & REHABILITATION PLLC
Entity Type:Organization
Organization Name:PINNACLE SPORTS PERFORMANCE & REHABILITATION PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MAYANK
Authorized Official - Middle Name:A
Authorized Official - Last Name:BHATT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:512-329-5500
Mailing Address - Street 1:300 BEARDSLEY LN BLDG B
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78746-4945
Mailing Address - Country:US
Mailing Address - Phone:512-329-5500
Mailing Address - Fax:512-329-0170
Practice Address - Street 1:300 BEARDSLEY LN BLDG B
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78746-4945
Practice Address - Country:US
Practice Address - Phone:512-329-5500
Practice Address - Fax:512-329-0170
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-09
Last Update Date:2011-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX05944111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty