Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207XS0106X | Orthopaedic Hand Surgeon | H6695 | TX |
N | 2082S0105X | Plastic Hand Surgeon | H6695 | TX |
Y | 2086S0122X | Plastic and Reconstructive Surgery | H6695 | TX |
NPI | 1083676050 |
---|---|
Provider Name | Dr. Robert Alan Weber JR. |
First Address | Dallas, TX 75284-4658 |
Second Address | Temple, TX 76508-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/04/2006 |
Last Update Date | 10/04/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
84W324 | BLUE SHIELD (01) | TX |
F51920 | (02) | TX |