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General NPI Number Information
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NPI Number | 1003690413
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Entity Type | Organization
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Legal Business Name | WINNIE COMMUNITY HOSPITAL LLC
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Dates
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Enumeration Date | 08/24/2023
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Last Update Date | 08/24/2023
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Provider Practice Location Address
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Address Line | 3560 DELAWARE ST STE 502
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City | BEAUMONT
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State | TX
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Zip | 77706-3061
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Country | US
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Telephone | 409-899-4472
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Fax | 409-899-9795
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Provider Business Mailing Address
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Address Line | 538 BROADWAY
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City | WINNIE
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State | TX
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Zip | 77665-7600
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Country | US
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Telephone | 409-296-6000
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Fax | 409-396-6372
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Authorized Official
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Title or Position | CORPORATE COORDINATOR
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Name | SHAKE HAQUE
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Credential |
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Telephone | 409-730-8054
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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