Provider Demographics
NPI:1407832686
Name:WINTERS, KARL NELSON (MD)
Entity Type:Individual
Prefix:DR
First Name:KARL
Middle Name:NELSON
Last Name:WINTERS
Suffix:
Gender:M
Credentials:MD
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 650865
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75265-0865
Mailing Address - Country:US
Mailing Address - Phone:972-715-5000
Mailing Address - Fax:972-715-9976
Practice Address - Street 1:6606 LBJ FWY
Practice Address - Street 2:SUITE 200
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75240-6533
Practice Address - Country:US
Practice Address - Phone:972-715-5000
Practice Address - Fax:972-715-9976
Is Sole Proprietor?:No
Enumeration Date:2005-12-19
Last Update Date:2015-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL5617207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX157598708Medicaid
TX8EH848OtherBCBS
TXP01446831OtherRR
TXP01446831OtherRR
F27561Medicare UPIN
TX8G2124OtherBCBS
TX8A3447Medicare UPIN
TXTXB115729Medicare UPIN
TX8A3436Medicare ID - Type Unspecified607K
TX157598706OtherMEDICAID CSHCN
TX157598704Medicaid
TX157598707Medicaid