Healthcare Provider Details

I. General information

NPI: 1427230580
Provider Name (Legal Business Name): WINFRED SCILLA TOVAR M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/30/2007
Last Update Date: 07/13/2022
Certification Date: 07/13/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6651 MAIN ST
HOUSTON TX
77030-2351
US

IV. Provider business mailing address

1 BAYLOR PLZ
HOUSTON TX
77030-3411
US

V. Phone/Fax

Practice location:
  • Phone: 832-826-6264
  • Fax:
Mailing address:
  • Phone: 832-355-2666
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number241588
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207VC0200X
TaxonomyCritical Care Medicine (Obstetrics & Gynecology) Physician
License NumberT5682
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code207LC0200X
TaxonomyCritical Care Medicine (Anesthesiology) Physician
License NumberT5682
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: