| Bob Winston MD PSC | |
|
201 Rue Beauregard Suite 100 Lafayette LA 70508 | |
| (337) 593-0830 | |
| (337) 593-0122 |
| Full Name | Bob Winston MD PSC |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 201 Rue Beauregard, Lafayette, Louisiana |
| Authorized Official Name and Position | Bob Winston (PSYCHIATRIST OWNER) |
| Authorized Official Contact | 3375930830 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bob Winston MD PSC 201 Rue Beauregard Suite 100 Lafayette LA 70508 Ph: (337) 593-0830 | Bob Winston MD PSC 201 Rue Beauregard Suite 100 Lafayette LA 70508 Ph: (337) 593-0830 |
| NPI Number | 1891864161 |
|---|---|
| Provider Enumeration Date | 11/08/2006 |
| Last Update Date | 07/28/2010 |
| Medicare PECOS PAC ID | 0345212742 |
|---|---|
| Medicare Enrollment ID | O20040806000831 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891864161 | NPI | - | NPPES |
| 1672025 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 11569R (Louisiana) | Primary |
| Provider Name | Emily J Wyatt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912197674 PECOS PAC ID: 9638267974 Enrollment ID: I20071120000171 |
| Provider Name | Bob Winston |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1619064367 PECOS PAC ID: 9638361587 Enrollment ID: I20110203001073 |
| Provider Name | Rebecca B Theriot |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730431297 PECOS PAC ID: 3375614910 Enrollment ID: I20130518000023 |
| Provider Name | Jessica Danielle Casey |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1821506726 PECOS PAC ID: 3072948942 Enrollment ID: I20200123000273 |
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