Provider Demographics
NPI:1649457276
Name:MICHAEL G. WINNIE, MD-PA
Entity type:Organization
Organization Name:MICHAEL G. WINNIE, MD-PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MD / OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:GLENN
Authorized Official - Last Name:WINNIE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:361-985-9850
Mailing Address - Street 1:5920 SARATOGA BLVD
Mailing Address - Street 2:# 610
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78414-4103
Mailing Address - Country:US
Mailing Address - Phone:361-985-9850
Mailing Address - Fax:361-985-9853
Practice Address - Street 1:5920 SARATOGA BLVD
Practice Address - Street 2:# 610
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78414-4103
Practice Address - Country:US
Practice Address - Phone:361-985-9850
Practice Address - Fax:361-985-9853
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-25
Last Update Date:2020-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX157386702Medicaid
TX00879UMedicare PIN