Provider Demographics
NPI:1801247960
Name:PINNACLE RETINA PLLC
Entity type:Organization
Organization Name:PINNACLE RETINA PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:NARENDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:336-485-4900
Mailing Address - Street 1:4900 KOGER BLVD
Mailing Address - Street 2:SUITE 125
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27407-2736
Mailing Address - Country:US
Mailing Address - Phone:336-485-4900
Mailing Address - Fax:336-485-4933
Practice Address - Street 1:4900 KOGER BLVD
Practice Address - Street 2:SUITE 125
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27407-2736
Practice Address - Country:US
Practice Address - Phone:843-566-4714
Practice Address - Fax:919-967-6647
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-29
Last Update Date:2018-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2015-00164207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty