Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | G0583 | TX |
N | 111NI0900X | Internist | G0583 | TX |
N | 207RC0200X | Critical Care Medicine | G0583 | TX |
Y | 207RI0200X | Infectious Disease | G0583 | TX |
N | 207RP1001X | Pulmonary Disease | G0583 | TX |
NPI | 1073672994 |
---|---|
Provider Name | Richard E Winn |
First Address | Lubbock, TX 79408-5865 |
Second Address | Lubbock, TX 79430-9410 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/12/2006 |
Last Update Date | 22/08/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
129062906 | (05) | TX |
823276 | TX MEDICARE- PREMIER (01) | TX |
8M2692 | BLUE CROSS BLUE SHIELD (01) | TX |
C23670 | (02) | TX |