Primary Pinnacle Diagnostic LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

PRIMARY PINNACLE DIAGNOSTIC LLC

Practice address

1903 Central Dr Ste 215
Bedford, TX 76021-5876

Phone

(817) 786-8991

Fax

(214) 261-5155

NPI assigned

Oct 16, 2017

Organization subpart

No

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

Authorized official

Name

Ronna Brooks

Title

VP Revenue Cycle

Phone

(972) 665-9930

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1508112000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1508371200000",
    "number": "1972014116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1138",
            "city": "ALLEN",
            "state": "TX",
            "postal_code": "750130018",
            "telephone_number": "972-665-9930",
            "fax_number": "214-261-5155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1903 CENTRAL DR STE 215",
            "city": "BEDFORD",
            "state": "TX",
            "postal_code": "760215876",
            "telephone_number": "817-786-8991",
            "fax_number": "214-261-5155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMARY PINNACLE DIAGNOSTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-16",
        "last_updated": "2017-10-19",
        "status": "A",
        "authorized_official_last_name": "BROOKS",
        "authorized_official_first_name": "RONNA",
        "authorized_official_title_or_position": "VP REVENUE CYCLE",
        "authorized_official_telephone_number": "972-665-9930"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Medical Laboratory in Bedford, TX
• Providers in Bedford, TX by specialty
• Clinical Medical Laboratory in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.