Provider Demographics
NPI:1942315460
Name:SCOTT-WINFUL, TERILYN RENE (MD)
Entity Type:Individual
Prefix:
First Name:TERILYN
Middle Name:RENE
Last Name:SCOTT-WINFUL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4708 ALLIANCE BLVD.
Mailing Address - Street 2:PAVILLION I SUITE #500
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093
Mailing Address - Country:US
Mailing Address - Phone:469-800-6580
Mailing Address - Fax:469-800-6590
Practice Address - Street 1:4708 ALLIANCE BLVD.
Practice Address - Street 2:PAVILLION I SUITE #500
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093
Practice Address - Country:US
Practice Address - Phone:469-800-6580
Practice Address - Fax:469-800-6590
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2022-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL4700207R00000X, 207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1661126-01Medicaid
TX8F4615OtherBCBS
TX1661126-02Medicaid
TX1661126-01Medicaid
TX8F4615OtherBCBS
TX8B5291Medicare PIN
TX8B9609Medicare PIN