Healthcare Provider Details

I. General information

NPI: 1720538242
Provider Name (Legal Business Name): CHRISTINE PINONES FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/07/2016
Last Update Date: 10/07/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

709 BARTON ST
HEARNE TX
77859-3009
US

IV. Provider business mailing address

1500 UNIVERSITY DR E SUITE 100
COLLEGE STATION TX
77840-2600
US

V. Phone/Fax

Practice location:
  • Phone: 979-279-3451
  • Fax: 979-279-5163
Mailing address:
  • Phone: 979-846-1100
  • Fax: 979-260-9390

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP131286
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: