Provider Demographics
NPI:1366524266
Name:WINSLOW, DAVID EVERETT (DO)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:EVERETT
Last Name:WINSLOW
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:651 N DENTON TAP RD
Mailing Address - Street 2:#190
Mailing Address - City:COPPELL
Mailing Address - State:TX
Mailing Address - Zip Code:75019-2007
Mailing Address - Country:US
Mailing Address - Phone:972-393-4686
Mailing Address - Fax:972-745-1464
Practice Address - Street 1:651 N DENTON TAP RD
Practice Address - Street 2:#190
Practice Address - City:COPPELL
Practice Address - State:TX
Practice Address - Zip Code:75019-2007
Practice Address - Country:US
Practice Address - Phone:972-393-4686
Practice Address - Fax:972-745-1464
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-19
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXH4804208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXE76962Medicare UPIN