Provider Demographics
NPI:1790784700
Name:PINKERTON, JODY (MD)
Entity Type:Individual
Prefix:
First Name:JODY
Middle Name:
Last Name:PINKERTON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16651 SOUTHWEST FWY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-2345
Mailing Address - Country:US
Mailing Address - Phone:713-774-5131
Mailing Address - Fax:713-481-6316
Practice Address - Street 1:16651 SOUTHWEST FWY
Practice Address - Street 2:SUITE 200
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-2345
Practice Address - Country:US
Practice Address - Phone:713-774-5131
Practice Address - Fax:713-481-6316
Is Sole Proprietor?:No
Enumeration Date:2005-07-20
Last Update Date:2011-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG55731207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX2008929OtherAETNA
TX3677670-003OtherCIGNA
TX1060287-02Medicaid
TX160040777OtherMEDICARE RR-SW LOCATION
TX88W583OtherBC/BS
TX160040777OtherMEDICARE RR-SW LOCATION
TX2008929OtherAETNA