MEDICARE: DR. MICHAEL F. WEAVER M.D.

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	207R00000X	Internal Medicine Physician	0101051584	VA
2	2084A0401X	Addiction Medicine (Psychiatry & Neurology) Physician	44530	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1982794533
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL F. WEAVER M.D.

Provider Business Mailing Address
First Line	:	1941 EAST RD
Second Line	:	BBSB 1222
City	:	HOUSTON
State	:	TX
Zip	:	77054-6010
Country	:	US
Telephone Number	:	713-486-2558
Fax Number	:	713-486-2618

Provider Business Practice Location Address
First Line	:	1941 EAST RD
Second Line	:	BBSB 1222
City	:	HOUSTON
State	:	TX
Zip	:	77054-6010
Country	:	US
Telephone Number	:	713-486-2552
Fax Number	:	713-486-2618

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

Provider Enumeration Date	:	10/13/2006
Last Update Date	:	03/26/2014

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