Healthcare Provider Details
I. General information
NPI: 1316195175
Provider Name (Legal Business Name): MELISSA WINN MD, PA
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/05/2008
Last Update Date: 09/05/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2911 MEDICAL ARTS ST STE 3
AUSTIN TX
78705-3302
US
IV. Provider business mailing address
2911 MEDICAL ARTS ST STE 3
AUSTIN TX
78705-3302
US
V. Phone/Fax
- Phone: 512-391-0175
- Fax: 512-476-4078
- Phone: 512-391-0175
- Fax: 512-476-4078
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207V00000X |
| Taxonomy | Obstetrics & Gynecology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MELISSA
GUZMAN
WINN
Title or Position: PRESIDENT
Credential: M.D.
Phone: 512-391-0175