Provider Demographics
NPI:1497957328
Name:TOLLETT, WINSTON EUGENE JR
Entity Type:Individual
Prefix:
First Name:WINSTON
Middle Name:EUGENE
Last Name:TOLLETT
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7457 HARWIN DR
Mailing Address - Street 2:SUITE 334
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77036-2018
Mailing Address - Country:US
Mailing Address - Phone:713-539-8175
Mailing Address - Fax:281-693-7135
Practice Address - Street 1:7457 HARWIN DR
Practice Address - Street 2:SUITE 334
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-2018
Practice Address - Country:US
Practice Address - Phone:713-539-8175
Practice Address - Fax:281-693-7135
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-04
Last Update Date:2015-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor