Provider Demographics
NPI:1699756387
Name:PINKSTON, MARIANNE J (MD)
Entity type:Individual
Prefix:DR
First Name:MARIANNE
Middle Name:J
Last Name:PINKSTON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 29425
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-0425
Mailing Address - Country:US
Mailing Address - Phone:210-615-0533
Mailing Address - Fax:210-615-0585
Practice Address - Street 1:4499 MEDICAL DR
Practice Address - Street 2:STE 170
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-3735
Practice Address - Country:US
Practice Address - Phone:210-615-7911
Practice Address - Fax:210-615-0585
Is Sole Proprietor?:No
Enumeration Date:2005-11-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK9871207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine