Healthcare Provider Details

I. General information

NPI: 1376937003
Provider Name (Legal Business Name): WINNIE COMMUNITY HOSPITAL, L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/19/2015
Last Update Date: 08/22/2025
Certification Date: 08/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20925 IH 10
VIDOR TX
77662-2557
US

IV. Provider business mailing address

538 BROADWAY
WINNIE TX
77665-7600
US

V. Phone/Fax

Practice location:
  • Phone: 409-769-2295
  • Fax: 409-769-3373
Mailing address:
  • Phone: 409-296-6000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA00871
License Number StateTX
# 5
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberAP1208950
License Number StateTX

VIII. Authorized Official

Name: MR. MUHAMMAD TAHIR JAVED
Title or Position: CEO
Credential:
Phone: 409-840-9601