Provider Demographics
NPI:1902351513
Name:VIRGINIA RUTH PINNEY
Entity Type:Organization
Organization Name:VIRGINIA RUTH PINNEY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN ASSISTANT
Authorized Official - Prefix:DR
Authorized Official - First Name:VIRGINIA
Authorized Official - Middle Name:RUTH
Authorized Official - Last Name:PINNEY
Authorized Official - Suffix:
Authorized Official - Credentials:PA-C
Authorized Official - Phone:832-515-6731
Mailing Address - Street 1:18 STARVIOLET ST
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77380-1442
Mailing Address - Country:US
Mailing Address - Phone:832-515-6731
Mailing Address - Fax:
Practice Address - Street 1:400 BYPASS LN
Practice Address - Street 2:100
Practice Address - City:LIVINGSTON
Practice Address - State:TX
Practice Address - Zip Code:77351-6351
Practice Address - Country:US
Practice Address - Phone:936-327-3843
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-24
Last Update Date:2016-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA09761363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1619354024OtherNPI