Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2086S0122X | Plastic and Reconstructive Surgery | 106074 | MN |
N | 2086S0122X | Plastic and Reconstructive Surgery | 55835 | MN |
Y | 2086S0122X | Plastic and Reconstructive Surgery | Q2962 | TX |
NPI | 1174884811 |
---|---|
Provider Name | Sebastian Winocour |
First Address | Houston, TX 77030-4101 |
Second Address | Houston, TX 77030-4101 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/05/2012 |
Last Update Date | 04/12/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
347412401 | (05) | TX |