Provider Demographics
NPI:1457590549
Name:PINNACLE HEALTH OCCMED CLINIC, LLC
Entity Type:Organization
Organization Name:PINNACLE HEALTH OCCMED CLINIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:L
Authorized Official - Last Name:PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:BS, AT/L
Authorized Official - Phone:956-702-4255
Mailing Address - Street 1:1201 N RAUL LONGORIA RD
Mailing Address - Street 2:STE. P
Mailing Address - City:SAN JUAN
Mailing Address - State:TX
Mailing Address - Zip Code:78589-3727
Mailing Address - Country:US
Mailing Address - Phone:956-702-4255
Mailing Address - Fax:956-702-4779
Practice Address - Street 1:1201 N RAUL LONGORIA RD
Practice Address - Street 2:STE. P
Practice Address - City:SAN JUAN
Practice Address - State:TX
Practice Address - Zip Code:78589-3727
Practice Address - Country:US
Practice Address - Phone:956-702-4255
Practice Address - Fax:956-702-4779
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-12
Last Update Date:2009-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9416111NR0400X, 111NX0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Multi-Specialty
No111NX0100XChiropractic ProvidersChiropractorOccupational HealthGroup - Multi-Specialty