Healthcare Provider Details

I. General information

NPI: 1871595819
Provider Name (Legal Business Name): LENIN PINNAMANENI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/10/2005
Last Update Date: 10/01/2025
Certification Date: 10/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9423 S US HIGHWAY 69
HUNTINGTON TX
75949-1515
US

IV. Provider business mailing address

PO BOX 1297
HUNTINGTON TX
75949-1297
US

V. Phone/Fax

Practice location:
  • Phone: 936-876-5719
  • Fax: 936-876-3308
Mailing address:
  • Phone: 936-876-5719
  • Fax: 936-876-3308

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberF8981
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: