MEDICARE: ANTHONY E PINCKNEY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	261QA0600X	Adult Day Care Clinic/Center
2	251C00000X	Developmentally Disabled Services Day Training Agency
3	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1225346158
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANTHONY E PINCKNEY

Provider Business Mailing Address
First Line	:	3612 ADA AVE
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76105-3422
Country	:	US
Telephone Number	:	682-230-5417
Fax Number	:	817-547-0023

Provider Business Practice Location Address
First Line	:	3612 ADA AVE
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76105-3422
Country	:	US
Telephone Number	:	682-230-5417
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MR. ANTHONY EUGENE PINCKNEY
Credential	:
Telephone Number	:	682-230-5417

Provider Enumeration Date	:	09/14/2010
Last Update Date	:	01/14/2026

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Directions to “ANTHONY E PINCKNEY ” Practice Location

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