Provider Demographics
NPI:1548299092
Name:WINNEBERGER, LINDA JO ANN (MD)
Entity type:Individual
Prefix:DR
First Name:LINDA
Middle Name:JO ANN
Last Name:WINNEBERGER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:3600 GASTON AVE
Mailing Address - Street 2:BARNETT TOWER, SUITE 707
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75246-1800
Mailing Address - Country:US
Mailing Address - Phone:214-823-6492
Mailing Address - Fax:214-818-9180
Practice Address - Street 1:3600 GASTON AVE
Practice Address - Street 2:WADLEY TOWER, SUITE 261
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75246-1800
Practice Address - Country:US
Practice Address - Phone:214-823-6492
Practice Address - Fax:214-818-9180
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2010-07-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXK9234207ZN0500X, 207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
No207ZN0500XAllopathic & Osteopathic PhysiciansPathologyNeuropathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8A2462OtherBLUE CROSS BLUE SHEILD
TX1775306Medicaid
TXI39163Medicare UPIN
TX1775306Medicaid