MEDICARE: STEPHEN WEINBERG, MDPA

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	174400000X	Specialist	G6421	TX

General Provider Information

NPI Number	:	1417127911
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STEPHEN WEINBERG, MDPA

Provider Business Mailing Address
First Line	:	3300 COLORADO BLVD
Second Line	:
City	:	DENTON
State	:	TX
Zip	:	76210-6864
Country	:	US
Telephone Number	:	940-566-2440
Fax Number	:	940-566-0180

Provider Business Practice Location Address
First Line	:	3300 COLORADO BLVD
Second Line	:
City	:	DENTON
State	:	TX
Zip	:	76210-6864
Country	:	US
Telephone Number	:	940-566-2440
Fax Number	:	940-566-0180

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. STEPHEN A. WEINBERG
Credential	:	M.D.
Telephone Number	:	940-566-2440

Provider Enumeration Date	:	03/11/2008
Last Update Date	:	05/07/2012

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