Provider Demographics
NPI:1710976907
Name:WINTER, BRUCE L (MD)
Entity Type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:L
Last Name:WINTER
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Gender:M
Credentials:MD
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Mailing Address - Street 1:2929 MOSSROCK
Mailing Address - Street 2:SUITE 104
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78230-5110
Mailing Address - Country:US
Mailing Address - Phone:210-377-0350
Mailing Address - Fax:210-377-2982
Practice Address - Street 1:2929 MOSSROCK
Practice Address - Street 2:SUITE 104
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78230-5110
Practice Address - Country:US
Practice Address - Phone:210-377-0350
Practice Address - Fax:210-377-2982
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-19
Last Update Date:2011-10-12
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Provider Licenses
StateLicense IDTaxonomies
TXH7363207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX152016502Medicaid
TXH63622Medicare UPIN
TX00110ZMedicare PIN