Provider Demographics
NPI:1538338405
Name:WINEY, DERRICK J
Entity type:Individual
Prefix:MR
First Name:DERRICK
Middle Name:J
Last Name:WINEY
Suffix:
Gender:M
Credentials:
Other - Prefix:MR
Other - First Name:BRANDON
Other - Middle Name:J
Other - Last Name:WINEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:8700 COMMERCE PARK DR
Mailing Address - Street 2:STE 218E
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77036-7497
Mailing Address - Country:US
Mailing Address - Phone:713-995-7454
Mailing Address - Fax:713-981-7774
Practice Address - Street 1:8700 COMMERCE PARK DR
Practice Address - Street 2:STE 218E
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-7497
Practice Address - Country:US
Practice Address - Phone:713-995-7454
Practice Address - Fax:713-981-7774
Is Sole Proprietor?:No
Enumeration Date:2008-02-26
Last Update Date:2008-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, Basic