Provider Demographics
NPI:1215935267
Name:WEINSTEIN, HOWARD LESLIE (DPM)
Entity type:Individual
Prefix:DR
First Name:HOWARD
Middle Name:LESLIE
Last Name:WEINSTEIN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 117535
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75011-7535
Mailing Address - Country:US
Mailing Address - Phone:972-492-4660
Mailing Address - Fax:972-492-0488
Practice Address - Street 1:3730 N JOSEY LANE
Practice Address - Street 2:STE 120
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75007-2439
Practice Address - Country:US
Practice Address - Phone:972-492-4660
Practice Address - Fax:972-492-0488
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-13
Last Update Date:2008-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPOD0874213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXFJ27Medicare ID - Type Unspecified
TX2636590001Medicare NSC
TXT16535Medicare UPIN