Provider Demographics
NPI:1326555350
Name:WINFUL, OLUWASEYITAN EMMANUEL (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:OLUWASEYITAN
Middle Name:EMMANUEL
Last Name:WINFUL
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2211 WATERFORD PARK ST
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77459-6952
Mailing Address - Country:US
Mailing Address - Phone:281-725-0734
Mailing Address - Fax:
Practice Address - Street 1:2211 WATERFORD PARK ST
Practice Address - Street 2:
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77459-6952
Practice Address - Country:US
Practice Address - Phone:281-725-0734
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-29
Last Update Date:2017-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1295130225100000X
AZ13500225100000X
OK4500225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist