=====================================================
General NPI Number Information
=====================================================
NPI Number | 1548395213
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | WINNIE COMMUNITY HOSPITAL, L.L.C.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/22/2007
-----------------------------------------------------
Last Update Date | 09/29/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 538 BROADWAY
-----------------------------------------------------
City | WINNIE
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77665-7600
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 409-296-6351
-----------------------------------------------------
Fax | 409-296-6386
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 538 BROADWAY
-----------------------------------------------------
City | WINNIE
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77665-7600
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 409-296-6351
-----------------------------------------------------
Fax | 409-296-6386
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CFO
-----------------------------------------------------
Name | DR. MOHAMMED DANISHMUND
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 409-730-8054
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207R00000X
-----------------------------------------------------
Taxonomy Name | Internal Medicine Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 208000000X
-----------------------------------------------------
Taxonomy Name | Pediatrics Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #4
-----------------------------------------------------
Taxonomy Code | 207P00000X
-----------------------------------------------------
Taxonomy Name | Emergency Medicine Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------