Provider Demographics
NPI:1356412019
Name:WINBURNE, JASON A (PT)
Entity type:Individual
Prefix:
First Name:JASON
Middle Name:A
Last Name:WINBURNE
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:18601 LYNDON B JOHNSON FWY STE 116
Mailing Address - Street 2:
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75150-5629
Mailing Address - Country:US
Mailing Address - Phone:972-270-2277
Mailing Address - Fax:972-270-2970
Practice Address - Street 1:4101 MCEWEN RD STE 100
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75244-5145
Practice Address - Country:US
Practice Address - Phone:972-701-0366
Practice Address - Fax:972-701-0372
Is Sole Proprietor?:No
Enumeration Date:2006-11-13
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8T4192OtherBCBS
TX8D5831Medicare PIN
TX8F24306Medicare PIN
TX8T4192OtherBCBS
TXP00332534Medicare PIN