Provider Demographics
NPI:1174897383
Name:PINON, RICHARD S (ATP)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:S
Last Name:PINON
Suffix:
Gender:M
Credentials:ATP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1908 GREENFIELD PLZ
Mailing Address - Street 2:
Mailing Address - City:BRYAN
Mailing Address - State:TX
Mailing Address - Zip Code:77802-3410
Mailing Address - Country:US
Mailing Address - Phone:979-268-6882
Mailing Address - Fax:979-260-3900
Practice Address - Street 1:1908 GREENFIELD PLZ
Practice Address - Street 2:
Practice Address - City:BRYAN
Practice Address - State:TX
Practice Address - Zip Code:77802-3410
Practice Address - Country:US
Practice Address - Phone:979-268-6882
Practice Address - Fax:979-260-3900
Is Sole Proprietor?:No
Enumeration Date:2012-03-06
Last Update Date:2012-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXATP50139247200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other