Provider Demographics
NPI:1346424801
Name:WINTER, JAMIE L (OTR, CHT)
Entity Type:Individual
Prefix:MRS
First Name:JAMIE
Middle Name:L
Last Name:WINTER
Suffix:
Gender:F
Credentials:OTR, CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 684986
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78768-4986
Mailing Address - Country:US
Mailing Address - Phone:512-444-4263
Mailing Address - Fax:512-444-4264
Practice Address - Street 1:1825 FORTVIEW RD STE 103
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78704-7654
Practice Address - Country:US
Practice Address - Phone:512-444-4263
Practice Address - Fax:512-444-4264
Is Sole Proprietor?:No
Enumeration Date:2007-12-19
Last Update Date:2018-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX111819225X00000X, 225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8L9640OtherMEDICARE PTAN
TX8T8000OtherBCBSTX PROVIDER NO