Provider Demographics
NPI:1538719471
Name:WINNIE KING AESTHETICS AND WELLNESS
Entity type:Organization
Organization Name:WINNIE KING AESTHETICS AND WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WINIFRED
Authorized Official - Middle Name:RENE
Authorized Official - Last Name:KING
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:936-224-7990
Mailing Address - Street 1:14637 PEBBLE BEND DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77068-2922
Mailing Address - Country:US
Mailing Address - Phone:936-224-7990
Mailing Address - Fax:936-224-3154
Practice Address - Street 1:14637 PEBBLE BEND DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77068-2922
Practice Address - Country:US
Practice Address - Phone:936-224-7990
Practice Address - Fax:936-224-3154
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-12
Last Update Date:2023-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty