Provider Demographics
NPI:1831207380
Name:WINTER, JAMES D
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:D
Last Name:WINTER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18333 EGRET BAY BLVD
Mailing Address - Street 2:STE 101
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77058
Mailing Address - Country:US
Mailing Address - Phone:281-488-5169
Mailing Address - Fax:281-335-7854
Practice Address - Street 1:18333 EGRET BAY BLVD
Practice Address - Street 2:STE 101
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77058
Practice Address - Country:US
Practice Address - Phone:281-488-5169
Practice Address - Fax:281-335-7854
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-25
Last Update Date:2013-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1900T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX83851NOtherBCBS
TX12472001OtherECPH
T16698Medicare UPIN
TX12472001OtherECPH