Provider Demographics
NPI:1629266267
Name:PINION, REBECCA A
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:A
Last Name:PINION
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:BECKY
Other - Middle Name:A
Other - Last Name:PINION
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:125 E GALVESTON ST
Mailing Address - Street 2:
Mailing Address - City:LEAGUE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77573-3891
Mailing Address - Country:US
Mailing Address - Phone:281-332-6407
Mailing Address - Fax:281-332-6407
Practice Address - Street 1:125 E GALVESTON ST
Practice Address - Street 2:
Practice Address - City:LEAGUE CITY
Practice Address - State:TX
Practice Address - Zip Code:77573-3891
Practice Address - Country:US
Practice Address - Phone:281-332-6407
Practice Address - Fax:281-332-6407
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-09
Last Update Date:2007-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
N/A335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0770350001Medicare NSC