Provider Demographics
NPI:1962453258
Name:PINNACLE THERAPY PC
Entity Type:Organization
Organization Name:PINNACLE THERAPY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT PHYSICAL THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:ANTONINO
Authorized Official - Middle Name:EDMOND
Authorized Official - Last Name:IANNELLO
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:713-622-2929
Mailing Address - Street 1:2400 AUGUSTA DR STE 155
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77057-4922
Mailing Address - Country:US
Mailing Address - Phone:713-622-2929
Mailing Address - Fax:713-622-2922
Practice Address - Street 1:2400 AUGUSTA DR STE 155
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77057-4922
Practice Address - Country:US
Practice Address - Phone:713-622-2929
Practice Address - Fax:713-622-2922
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-12
Last Update Date:2018-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1149730225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00W860Medicare ID - Type UnspecifiedGROUP NUMBER