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General NPI Number Information
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NPI Number | 1841774320
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Entity Type | Individual
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Provider Name | ANGELA ANN MCDANIEL WINSKO
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Gender | Female
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Dates
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Enumeration Date | 09/20/2018
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Last Update Date | 10/08/2018
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Provider Practice Location Address
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Address Line | 1421 S. BEGLIS PKWY
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City | SULPHUR
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State | LA
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Zip | 70663-5603
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Country | US
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Telephone | 337-528-9918
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Fax |
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Provider Business Mailing Address
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Address Line | 1180 SHAKESPEARE DR
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City | BEAUMONT
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State | TX
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Zip | 77706-4137
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Country | US
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Telephone | 409-767-0148
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208U00000X
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Taxonomy Name | Clinical Pharmacology Physician
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License Number | PST.022688
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License Number State | LA
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