MEDICARE: THOMAS R WEISS MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	G0273	TX

General Provider Information

NPI Number	:	1063414928
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	THOMAS R WEISS MD

Provider Business Mailing Address
First Line	:	8122 DATAPOINT DR
Second Line	:	SUITE 1010
City	:	SAN ANTONIO
State	:	TX
Zip	:	78229-3272
Country	:	US
Telephone Number	:	210-614-5561
Fax Number	:	210-614-8351

Provider Business Practice Location Address
First Line	:	8122 DATAPOINT DR
Second Line	:	SUITE 1010
City	:	SAN ANTONIO
State	:	TX
Zip	:	78229-3272
Country	:	US
Telephone Number	:	210-614-5561
Fax Number	:	210-614-8351

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/11/2005
Last Update Date	:	12/28/2011

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