Provider Demographics
NPI:1376937003
Name:WINNIE COMMUNITY HOSPITAL, L.L.C.
Entity Type:Organization
Organization Name:WINNIE COMMUNITY HOSPITAL, L.L.C.
Other - Org Name:RICELAND CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MUHAMMAD
Authorized Official - Middle Name:TAHIR
Authorized Official - Last Name:JAVED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:409-840-9601
Mailing Address - Street 1:538 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:WINNIE
Mailing Address - State:TX
Mailing Address - Zip Code:77665-7600
Mailing Address - Country:US
Mailing Address - Phone:409-296-6000
Mailing Address - Fax:
Practice Address - Street 1:85 IH 10 N STE 112
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77707-2560
Practice Address - Country:US
Practice Address - Phone:409-239-5139
Practice Address - Fax:409-347-8856
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-19
Last Update Date:2023-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207R00000X, 207RE0101X, 363L00000X, 363LF0000X
TXPA00871363A00000X
TXAP1208950363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Multi-Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXE7808OtherMEDICAL LICENSE