Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152WC0802X | Optomitrist - Corneal and Contact Lenses | 8046 | TX |
NPI | 1306229869 |
---|---|
Provider Name | Dr. Richard Edward Weisbarth |
First Address | Fort Worth, TX 76134-2001 |
Second Address | Fort Worth, TX 76134-2001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/07/2015 |
Last Update Date | 02/07/2015 |