MEDICARE: PINNACLE ADULT CARE INC.

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171W00000X	Contractor	118432	TX

General Provider Information

NPI Number	:	1922198464
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PINNACLE ADULT CARE INC.

Provider Business Mailing Address
First Line	:	3321 DIXIE DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77021-1146
Country	:	US
Telephone Number	:	713-440-0913
Fax Number	:	713-440-0919

Provider Business Practice Location Address
First Line	:	3321 DIXIE DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77021-1146
Country	:	US
Telephone Number	:	713-440-0913
Fax Number	:	713-440-0919

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MS. MARGERINE WHITE WILLIAMS
Credential	:
Telephone Number	:	713-440-0913

Provider Enumeration Date	:	10/13/2006
Last Update Date	:	08/22/2020

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