Provider Demographics
NPI:1225261621
Name:WINBORNNE, C DIANE (LO,BOCO, CFOM)
Entity Type:Individual
Prefix:
First Name:C
Middle Name:DIANE
Last Name:WINBORNNE
Suffix:
Gender:F
Credentials:LO,BOCO, CFOM
Other - Prefix:
Other - First Name:C
Other - Middle Name:DIANE
Other - Last Name:BROOKS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:729 BEDFORD-EULESS RD STE 208
Mailing Address - Street 2:
Mailing Address - City:HURST
Mailing Address - State:TX
Mailing Address - Zip Code:76053-3941
Mailing Address - Country:US
Mailing Address - Phone:972-226-6496
Mailing Address - Fax:
Practice Address - Street 1:729 BEDFORD-EULESS RD STE 208
Practice Address - Street 2:
Practice Address - City:HURST
Practice Address - State:TX
Practice Address - Zip Code:76053-3941
Practice Address - Country:US
Practice Address - Phone:817-268-4900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-01
Last Update Date:2009-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist