MEDICARE: WINSLOW MEDICAL CENTER, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	D4453	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1518286418
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WINSLOW MEDICAL CENTER, INC

Provider Business Mailing Address
First Line	:	4002 BURKE RD
Second Line	:
City	:	PASADENA
State	:	TX
Zip	:	77504-3451
Country	:	US
Telephone Number	:	281-606-2020
Fax Number	:	280-606-2021

Provider Business Practice Location Address
First Line	:	4002 BURKE RD
Second Line	:
City	:	PASADENA
State	:	TX
Zip	:	77504-3451
Country	:	US
Telephone Number	:	281-606-2020
Fax Number	:	280-606-2021

Authorized Official
Title or Position	:	MEDICAL DIRECTOR
Name	:	DR. RAY EUGENE WARREN
Credential	:	M.D
Telephone Number	:	281-360-7502

Provider Enumeration Date	:	05/18/2010
Last Update Date	:	05/18/2010

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Directions to “WINSLOW MEDICAL CENTER, INC ” Practice Location

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