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NPI Code Detail

MEDICARE: MS. WINIFRED RENE KING MD

MEDICARE: MS. WINIFRED RENE KING MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208D00000XGeneral Practice PhysicianM5295TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
38R8316OTHERTXBCBS

General Provider Information

NPI Number : 1114931847
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. WINIFRED RENE KING MD
Provider Business Mailing Address
First Line : 14637 PEBBLE BEND DR
Second Line :
City : HOUSTON
State : TX
Zip : 77068-2922
Country : US
Telephone Number : 936-224-7990
Fax Number : 936-224-3154
Provider Business Practice Location Address
First Line : 14637 PEBBLE BEND DR
Second Line :
City : HOUSTON
State : TX
Zip : 77068-2922
Country : US
Telephone Number : 936-224-7990
Fax Number : 936-224-3154
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/28/2006
Last Update Date : 05/17/2023

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