1104119213 NPI number — JOHN R. WINDROW, D.D.S.,M.S.,INC.

Table of content: (NPI 1104119213)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1104119213 NPI number — JOHN R. WINDROW, D.D.S.,M.S.,INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
JOHN R. WINDROW, D.D.S.,M.S.,INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1104119213
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/23/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1909 AVE E
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HONDO
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78861-2531
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
830-426-3800
Provider Business Mailing Address Fax Number:
830-426-4311

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1909 AVE E
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HONDO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78861-2531
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
830-426-3800
Provider Business Practice Location Address Fax Number:
830-426-4311
Provider Enumeration Date:
05/23/2011

Additional Information

Authorized Official

Authorized Official Last Name:
WINDROW
Authorized Official First Name:
JOHN
Authorized Official Middle Name:
ROBERT
Authorized Official Title or Position:
PRESIDENT/SECRETARY
Authorized Official Telephone Number:
830-426-3800

Provider Taxonomy Codes

  • Taxonomy code: 1223X0400X , with the licence number:  8344 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 193400000X . This is a "TAXONOMY NUMBER" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com