Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204C00000X | Sports Medicine Doctor | 73137 | FL |
N | 204D00000X | Neuromusculoskeletal Medicine (NMM) | 73137 | FL |
Y | 207P00000X | Emergency Physician | M5295 | TX |
NPI | 1114931847 |
---|---|
Provider Name | Winifred Rene King |
First Address | The Woodlands, TX 77382-4500 |
Second Address | The Woodlands, TX 77382-4500 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/07/2006 |
Last Update Date | 17/03/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
189062602 | (05) | TX |
189062604 | (05) | TX |
8R8316 | BCBS (01) | TX |
D94026 | (02) | FL |
D94026 | (02) | TX |