Provider Demographics
NPI:1275709206
Name:WINKELMANN, TARA LYN (MD)
Entity Type:Individual
Prefix:
First Name:TARA
Middle Name:LYN
Last Name:WINKELMANN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:17183 INTERSTATE 45 S STE 410
Mailing Address - Street 2:
Mailing Address - City:SHENANDOAH
Mailing Address - State:TX
Mailing Address - Zip Code:77385-3313
Mailing Address - Country:US
Mailing Address - Phone:281-602-7380
Mailing Address - Fax:281-602-7386
Practice Address - Street 1:17183 INTERSTATE 45 S STE 410
Practice Address - Street 2:
Practice Address - City:SHENANDOAH
Practice Address - State:TX
Practice Address - Zip Code:77385
Practice Address - Country:US
Practice Address - Phone:281-602-7380
Practice Address - Fax:281-602-7386
Is Sole Proprietor?:No
Enumeration Date:2008-04-30
Last Update Date:2022-07-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXM9744207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8R8344OtherBLUE CROSS BLUE SHIELD OF TEXAS