MEDICARE: RICHARD H. WEINER, DPM, P.A.

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	213ES0131X	Foot Surgery Podiatrist	520	TX

General Provider Information

NPI Number	:	1629127337
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RICHARD H. WEINER, DPM, P.A.

Provider Business Mailing Address
First Line	:	4523 W LOVERS LN
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75209-3131
Country	:	US
Telephone Number	:	214-351-2180
Fax Number	:	214-351-3886

Provider Business Practice Location Address
First Line	:	4523 W LOVERS LN
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75209-3131
Country	:	US
Telephone Number	:	214-351-2180
Fax Number	:	214-351-3886

Authorized Official
Title or Position	:	GENERAL PARTNER
Name	:	DR. RICHARD HENRY WEINER
Credential	:	D.P.M.
Telephone Number	:	214-351-2180

Provider Enumeration Date	:	01/10/2007
Last Update Date	:	08/22/2020

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