MEDICARE: MR. DERRICK J WINEY

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	146N00000X	Basic Emergency Medical Technician

General Provider Information

NPI Number	:	1538338405
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. DERRICK J WINEY

Provider Business Mailing Address
First Line	:	8700 COMMERCE PARK DR
Second Line	:	STE 218E
City	:	HOUSTON
State	:	TX
Zip	:	77036-7497
Country	:	US
Telephone Number	:	713-995-7454
Fax Number	:	713-981-7774

Provider Business Practice Location Address
First Line	:	8700 COMMERCE PARK DR
Second Line	:	STE 218E
City	:	HOUSTON
State	:	TX
Zip	:	77036-7497
Country	:	US
Telephone Number	:	713-995-7454
Fax Number	:	713-981-7774

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/26/2008
Last Update Date	:	02/26/2008

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Directions to “ MR. DERRICK J WINEY ” Practice Location

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