1376899427 NPI number — ROBERT PINE, PLLC DBA HILLS AND VALLEYS COUNSELING

Table of content: (NPI 1376899427)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1376899427 NPI number — ROBERT PINE, PLLC DBA HILLS AND VALLEYS COUNSELING

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ROBERT PINE, PLLC DBA HILLS AND VALLEYS COUNSELING
Provider Last Name:
Provider First Name:
Provider Middle Name:
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Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
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Provider Other Middle Name:
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NPI Number Information

NPI Number:
1376899427
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/26/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6804 LOCKSLEY CIR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PLANO
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75023-1063
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
469-964-5687
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4601 OLD SHEPARD PL
Provider Second Line Business Practice Location Address:
SUITE 101
Provider Business Practice Location Address City Name:
PLANO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75093-5279
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
469-964-5687
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/26/2012

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
PINE
Authorized Official First Name:
ROBERT
Authorized Official Middle Name:
ANTHONY
Authorized Official Title or Position:
MEMBER MANAGER
Authorized Official Telephone Number:
469-964-5687

Provider Taxonomy Codes

  • Taxonomy code: 101YP2500X , with the licence number:  64634 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)