Provider Demographics
NPI:1265986244
Name:PINEMONT MEDICAL
Entity type:Organization
Organization Name:PINEMONT MEDICAL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DAMION
Authorized Official - Middle Name:
Authorized Official - Last Name:SCRUGGS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-834-4365
Mailing Address - Street 1:5400 PINEMONT DR
Mailing Address - Street 2:SUITE 107-108
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77092-3429
Mailing Address - Country:US
Mailing Address - Phone:832-834-4365
Mailing Address - Fax:832-834-4250
Practice Address - Street 1:5400 PINEMONT DR
Practice Address - Street 2:SUITE 107-108
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77092-3429
Practice Address - Country:US
Practice Address - Phone:832-834-4365
Practice Address - Fax:832-834-4250
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-08
Last Update Date:2016-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare