Provider Demographics
NPI:1659410348
Name:PINER, JUDITH (DO)
Entity Type:Individual
Prefix:DR
First Name:JUDITH
Middle Name:
Last Name:PINER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3213 HOLLY RD
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78415-3216
Mailing Address - Country:US
Mailing Address - Phone:361-853-4300
Mailing Address - Fax:361-853-4310
Practice Address - Street 1:3213 HOLLY RD
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78415-3216
Practice Address - Country:US
Practice Address - Phone:361-853-4300
Practice Address - Fax:361-853-4310
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2010-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG9513208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXA67506Medicare UPIN