Provider Demographics
NPI:1447826383
Name:PINNACLE HEALTHCARE PLLC
Entity type:Organization
Organization Name:PINNACLE HEALTHCARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MOSES
Authorized Official - Middle Name:
Authorized Official - Last Name:CAMPOS
Authorized Official - Suffix:
Authorized Official - Credentials:PA-C
Authorized Official - Phone:956-566-3079
Mailing Address - Street 1:10306 N 27TH LN
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504-2188
Mailing Address - Country:US
Mailing Address - Phone:956-566-3079
Mailing Address - Fax:
Practice Address - Street 1:1616 N CONWAY AVE
Practice Address - Street 2:
Practice Address - City:MISSION
Practice Address - State:TX
Practice Address - Zip Code:78572-4004
Practice Address - Country:US
Practice Address - Phone:956-580-9966
Practice Address - Fax:956-580-1964
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-01
Last Update Date:2024-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1558680009Medicaid