Provider Demographics
NPI:1760980528
Name:WINLAND, ELIZABETH JOANNE (MS, LAT, ATC, LMT)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:JOANNE
Last Name:WINLAND
Suffix:
Gender:F
Credentials:MS, LAT, ATC, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14104 ESPERANZA DR
Mailing Address - Street 2:
Mailing Address - City:HASLET
Mailing Address - State:TX
Mailing Address - Zip Code:76052-4870
Mailing Address - Country:US
Mailing Address - Phone:817-729-1454
Mailing Address - Fax:
Practice Address - Street 1:14104 ESPERANZA DR
Practice Address - Street 2:
Practice Address - City:HASLET
Practice Address - State:TX
Practice Address - Zip Code:76052-4870
Practice Address - Country:US
Practice Address - Phone:817-729-1454
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-26
Last Update Date:2018-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXMT122141225700000X
TXAT53902255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist