Provider Demographics
NPI:1174884811
Name:WINOCOUR, SEBASTIAN (MD)
Entity type:Individual
Prefix:
First Name:SEBASTIAN
Middle Name:
Last Name:WINOCOUR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1977 BUTLER BLVD STE E6.100
Mailing Address - Street 2:BAYLOR COLLEGE OF MEDICINE
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-4101
Mailing Address - Country:US
Mailing Address - Phone:713-798-6141
Mailing Address - Fax:713-798-5014
Practice Address - Street 1:1977 BUTLER BLVD STE E6.100
Practice Address - Street 2:BAYLOR COLLEGE OF MEDICINE
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-4101
Practice Address - Country:US
Practice Address - Phone:713-798-6141
Practice Address - Fax:713-798-5014
Is Sole Proprietor?:No
Enumeration Date:2012-05-30
Last Update Date:2020-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1060742086S0122X
MN558352086S0122X
TXQ29622086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX347412401Medicaid
MN240000403Medicare PIN
TX414922YKQHMedicare PIN