Individual provider Active NPI

Mark Pincock, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • League City, TX
National Provider Identifier
1164300190
Registry record updated Aug 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
1184697 Issued in TX
Practice address
2785 Gulf Fwy S Ste 2.200
League City, TX 77573-4979
Phone
(888) 886-2543
NPI assigned
Aug 26, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 26, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 1184697 TX Primary

Addresses

Primary practice location

2785 Gulf Fwy S Ste 2.200
League City, TX 77573-4979

Mailing address

2785 Gulf Fwy S Ste 2.200
League City, TX 77573-4979

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251215003546 TX Practitioner - Nurse Practitioner 1850885054 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

PO Box
Dallas, TX 75265

PO Box
650859 Dept. 710
Dallas, TX 75265-0859

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1184697TXMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Utmb Faculty Group Practice CurrentSince Dec 8, 2025 Accepting new patients
University of Texas Medical Branch at Galveston PastSince Sep 3, 2025 Accepting new patients

Locations

2020 E Highway 6
Alvin, TX 77511
Phone (281) 585-2530

195 N 11th St
Beaumont, TX 77702
Phone (409) 838-0045

701 E Davis St
Ste A
Conroe, TX 77301
Phone (936) 525-2800

301 University Blvd
Galveston, TX 77555
Phone (409) 747-1883

511 Park Grove Dr
Katy, TX 77450
Phone (281) 398-7001

2785 Gulf Fwy S
Ste 2200
League City, TX 77573
Phone (409) 772-3695

2785 Gulf Fwy S
League City, TX 77573
Phone (409) 772-3695

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1756166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756166400000",
    "number": "1164300190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2785 GULF FWY S STE 2.200",
            "city": "LEAGUE CITY",
            "state": "TX",
            "postal_code": "775734979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2785 GULF FWY S STE 2.200",
            "city": "LEAGUE CITY",
            "state": "TX",
            "postal_code": "775734979",
            "telephone_number": "888-886-2543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PINCOCK",
        "first_name": "MARK",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-08-26",
        "last_updated": "2025-08-26",
        "certification_date": "2025-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "1184697",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in League City, TX

Sources for this page

Verify at the official NPI Registry.