Provider Demographics
NPI:1629067251
Name:WINN, BRIAN E (MD)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:E
Last Name:WINN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:BRIAN
Other - Middle Name:E
Other - Last Name:WINN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:1303 MCCULLOUGH AVE
Mailing Address - Street 2:SUITE 600
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78212-5609
Mailing Address - Country:US
Mailing Address - Phone:210-225-2551
Mailing Address - Fax:210-225-3896
Practice Address - Street 1:1303 MCCULLOUGH AVE
Practice Address - Street 2:SUITE 600
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78212-5609
Practice Address - Country:US
Practice Address - Phone:210-225-2551
Practice Address - Fax:210-225-3896
Is Sole Proprietor?:No
Enumeration Date:2005-10-17
Last Update Date:2021-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH5280207RR0500X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX035668502Medicaid
TXP00871878OtherRAILROAD MEDICARE
TX035668501Medicaid
TX110109944OtherRAILROAD MEDICARE
TXG02261Medicare UPIN
TX8F24087Medicare PIN
TX00R94YMedicare PIN