Provider Demographics
NPI:1518348002
Name:PIN OAK MEDICAL CENTER LLC
Entity Type:Organization
Organization Name:PIN OAK MEDICAL CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARLA
Authorized Official - Middle Name:
Authorized Official - Last Name:GUICE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:331-305-2813
Mailing Address - Street 1:1000 JORIE BLVD
Mailing Address - Street 2:370
Mailing Address - City:OAK BROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60523-2214
Mailing Address - Country:US
Mailing Address - Phone:331-305-2813
Mailing Address - Fax:
Practice Address - Street 1:1334 PIN OAK RD
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-6849
Practice Address - Country:US
Practice Address - Phone:331-305-2813
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-10
Last Update Date:2016-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty