Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | F9059 | TX |
NPI | 1093701872 |
---|---|
Provider Name | Richard L Weiner |
First Address | Plano, TX 75093-8201 |
Second Address | Plano, TX 75093-8201 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/09/2005 |
Last Update Date | 25/01/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
129594105 | (05) | TN |
D69241 | (02) | TX |