Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 122300000X | Dentist | 14832 | TX |
N | 1223D0001X | Dental Public Health | 14832 | TX |
NPI | 1255402103 |
---|---|
Provider Name | Dr. Maureen Elizabeth Weber |
First Address | Tyler, TX 75702-7822 |
Second Address | Tyler, TX 75702-7822 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/11/2006 |
Last Update Date | 08/07/2007 |