Richard E Weaver
Dentist, General Practice in Beaumont, TX. Organization (NPI-2).
NPI number1972896751
StatusActive
Last updated in NPPESMay 26, 2011
Details
- NPI
- 1972896751
- Entity type
- Organization (NPI-2)
- Legal business name
- Richard E Weaver
- Organization subpart
- No
- Enumeration date
- May 26, 2011
- Last updated
- May 26, 2011
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | 12088 | TX | Yes |
Practice location
3590 Blackmon Ln#1
Beaumont, TX 77706-7956
Phone 409-898-8602 · Fax 409-898-8618
Mailing address
3590 Blackmon Ln#1
Beaumont, TX 77706-7956
Phone 409-898-8602 · Fax 409-898-8618
Authorized official
Julie Deanne Davis
Finance Manager
4098988602
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