Provider Demographics
NPI:1871703520
Name:PINEDA, ANTHONY G (MS, MED, LAT)
Entity type:Individual
Prefix:MR
First Name:ANTHONY
Middle Name:G
Last Name:PINEDA
Suffix:
Gender:M
Credentials:MS, MED, LAT
Other - Prefix:
Other - First Name:ANTHONY
Other - Middle Name:G
Other - Last Name:PINEDA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS, MED, LAT
Mailing Address - Street 1:10822 BARKER GATE CT
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77433-2533
Mailing Address - Country:US
Mailing Address - Phone:281-704-0513
Mailing Address - Fax:
Practice Address - Street 1:10822 BARKER GATE CT
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77433-2533
Practice Address - Country:US
Practice Address - Phone:281-704-0513
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2022-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
174H00000X, 225400000X, 226300000X
TXAT38442255A2300X, 2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
No174H00000XOther Service ProvidersHealth Educator
No225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner
No226300000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersKinesiotherapist