Healthcare Provider Details

I. General information

NPI: 1063896520
Provider Name (Legal Business Name): PINNACLE ANESTHESIA CONSULTANTS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/15/2015
Last Update Date: 07/15/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1411 N BECKLEY AVE PAV. III, SUITE 152
DALLAS TX
75203-1259
US

IV. Provider business mailing address

PO BOX 650866
DALLAS TX
75265-0866
US

V. Phone/Fax

Practice location:
  • Phone: 214-948-7700
  • Fax: 214-948-7701
Mailing address:
  • Phone: 972-715-5000
  • Fax: 972-715-9976

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number StateTX
# 4
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number StateTX
# 5
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number StateTX

VIII. Authorized Official

Name: JAMES SCOTT HOLLIDAY
Title or Position: OFFICER
Credential: DO
Phone: 972-715-5000