Provider Demographics
NPI:1679595417
Name:WATKINS, WINSTON E JR (MD)
Entity Type:Individual
Prefix:
First Name:WINSTON
Middle Name:E
Last Name:WATKINS
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1315 ST JOSEPH PKWY
Mailing Address - Street 2:STE 1507
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77002-8233
Mailing Address - Country:US
Mailing Address - Phone:713-650-6556
Mailing Address - Fax:713-650-8539
Practice Address - Street 1:1315 ST JOSEPH PKWY
Practice Address - Street 2:STE 1507
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77002-8233
Practice Address - Country:US
Practice Address - Phone:713-650-6556
Practice Address - Fax:713-650-8539
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2013-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG8491207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX127030806Medicaid
TX8W2120OtherBCBS
TX8F3592Medicare PIN
TX8W2120OtherBCBS