MEDICARE: LISA MARIE WEEKS 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	207V00000X	Obstetrics & Gynecology Physician	01061842A	IN

General Provider Information

NPI Number	:	1154359198
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LISA MARIE WEEKS MD

Provider Business Mailing Address
First Line	:	BROOKE ARMY MEDICAL CENTER
Second Line	:	3551 ROGER BROOKE DR
City	:	JBSA FORT SAM HOUSTON
State	:	TX
Zip	:	78234-4504
Country	:	US
Telephone Number	:	210-539-9271
Fax Number	:

Provider Business Practice Location Address
First Line	:	BROOKE ARMY MEDICAL CENTER
Second Line	:	3551 ROGER BROOKE DR
City	:	JBSA FORT SAM HOUSTON
State	:	TX
Zip	:	78234-4504
Country	:	US
Telephone Number	:	210-539-9271
Fax Number	:

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

Provider Enumeration Date	:	06/29/2006
Last Update Date	:	08/24/2020

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