Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0122X | Plastic and Reconstructive Surgery | E4959 | TX |
NPI | 1124080031 |
---|---|
Provider Name | Dr. Lyle D Weeks |
First Address | El Paso, TX 79902-3590 |
Second Address | El Paso, TX 79902-3590 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/04/2006 |
Last Update Date | 17/03/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
126386 | (05) | TX |
B27456 | (02) |