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James Russell Winn

Family Medicine

Allopathic & Osteopathic Physicians

1201 8th Ave., Fort Worth, TX 76104-4104

PECOS Enrollment

This provider is enrolled in PECOS as JAMES WINN.

Based on the most recent information from CMS, provider James Russell Winn is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 3 days ago.

Profile Details

Provider ID
1689782328
Provider Type
Individual
Full Name
Winn, James Russell
Credential
M.D.

Gender
Male
Sole Proprietor
No
Enumeration Date
8/25/2006
Last Updated
10/14/2011

Contact Information

Practice Location

1201 8th Ave., Fort Worth, TX 76104-4104

(817) 335-8478

(817) 882-9910

Mailing Location

P.O. Box 961205, Fort Worth, TX 76161-1205

(817) 740-8400

(817) 882-9910

Provider Taxonomies

Code	Description	License
Code 207Q00000X Primary	Description Family Medicine Allopathic & Osteopathic Physicians	License D4364 Texas

Provider Identifiers

ID	Description	Issuer
ID 033987102	Description Medicaid	Issuer Unlisted Texas

James Russell Winn

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

Edwards, Ricky D

Khan, Ajaz Omer

Cahill, Timothy

Sang, Nancy

Mathur, Monika

Slee, Barbara Lynn

Katzen, Kevin Dean

Grant, Karen M

Reeve, David L

Katzen, Kenneth Lee