Provider Demographics
NPI:1104119213
Name:JOHN R. WINDROW, D.D.S.,M.S.,INC.
Entity type:Organization
Organization Name:JOHN R. WINDROW, D.D.S.,M.S.,INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/SECRETARY
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:WINDROW
Authorized Official - Suffix:
Authorized Official - Credentials:DDS,MS
Authorized Official - Phone:830-426-3800
Mailing Address - Street 1:1909 AVE E
Mailing Address - Street 2:
Mailing Address - City:HONDO
Mailing Address - State:TX
Mailing Address - Zip Code:78861-2531
Mailing Address - Country:US
Mailing Address - Phone:830-426-3800
Mailing Address - Fax:830-426-4311
Practice Address - Street 1:1909 AVE E
Practice Address - Street 2:
Practice Address - City:HONDO
Practice Address - State:TX
Practice Address - Zip Code:78861-2531
Practice Address - Country:US
Practice Address - Phone:830-426-3800
Practice Address - Fax:830-426-4311
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JOHN R. WINDROW,D.D.S.,M.S.,INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-05-23
Last Update Date:2011-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX83441223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX193400000XOtherTAXONOMY NUMBER