Provider Demographics
NPI:1447716337
Name:WINN, ANTHONY DOUGLAS (DPT)
Entity type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:DOUGLAS
Last Name:WINN
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:515 CONGRESS AVE STE N
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78701-3563
Mailing Address - Country:US
Mailing Address - Phone:512-450-5051
Mailing Address - Fax:
Practice Address - Street 1:515 CONGRESS AVE STE N
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78701-3563
Practice Address - Country:US
Practice Address - Phone:512-450-5051
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-15
Last Update Date:2019-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1315989225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist