Provider Demographics
NPI:1447458583
Name:LETREISE D. WINKFIELD, M.D., P.A.
Entity type:Organization
Organization Name:LETREISE D. WINKFIELD, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:LETREISE
Authorized Official - Middle Name:D
Authorized Official - Last Name:WINKFIELD
Authorized Official - Suffix:X
Authorized Official - Credentials:MD
Authorized Official - Phone:956-682-0091
Mailing Address - Street 1:4829 S JACKSON RD
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78539-9793
Mailing Address - Country:US
Mailing Address - Phone:956-682-0091
Mailing Address - Fax:956-682-0846
Practice Address - Street 1:4829 S JACKSON RD
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-9793
Practice Address - Country:US
Practice Address - Phone:956-682-0091
Practice Address - Fax:956-682-0846
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-10
Last Update Date:2011-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK4836261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXG83632OtherUPIN
TX172762001Medicaid
TX172762001Medicaid