Healthcare Provider Details

I. General information

NPI: 1568450286
Provider Name (Legal Business Name): WINLOVE P EDUARTE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 10/06/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18951 N MEMORIAL DR
HUMBLE TX
77338-4217
US

IV. Provider business mailing address

800 ROCKMEAD DR S:210
KINGWOOD TX
77339
US

V. Phone/Fax

Practice location:
  • Phone: 281-359-7788
  • Fax: 281-359-7888
Mailing address:
  • Phone: 281-359-7788
  • Fax: 281-359-7888

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberF5899
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: