Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | G7609 | TX |
N | 207VE0102X | Reproductive Endocrinologist | G7609 | TX |
NPI | 1093777922 |
---|---|
Provider Name | Dr. Thomas John Wincek |
First Address | Dallas, TX 75284-4658 |
Second Address | Temple, TX 76508-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/04/2006 |
Last Update Date | 12/03/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
807561 | BLUE SHIELD (01) | TX |
C23660 | (02) | TX |