Provider Demographics
NPI:1639507189
Name:PINNACLE HAND SURGERY GROUP, PA
Entity Type:Organization
Organization Name:PINNACLE HAND SURGERY GROUP, PA
Other - Org Name:PINNACLE HAND CENTER AND/OR PINNACLE HAND CONSULTANTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN/ SURGEON
Authorized Official - Prefix:
Authorized Official - First Name:RANDOLPH
Authorized Official - Middle Name:A
Authorized Official - Last Name:LOPEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:832-407-0866
Mailing Address - Street 1:5315 CYPRESS CREEK PKWY STE B
Mailing Address - Street 2:#334
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77069-4410
Mailing Address - Country:US
Mailing Address - Phone:713-522-5111
Mailing Address - Fax:713-522-6111
Practice Address - Street 1:1355 W GRAY ST
Practice Address - Street 2:STE B
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77019-4019
Practice Address - Country:US
Practice Address - Phone:713-522-5111
Practice Address - Fax:713-522-6111
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-21
Last Update Date:2013-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM04742086S0105X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0105XAllopathic & Osteopathic PhysiciansSurgerySurgery of the HandGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1780789719OtherNPI