Healthcare Provider Details

I. General information

NPI: 1437795655
Provider Name (Legal Business Name): KENT WEINHEIMER MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/22/2019
Last Update Date: 11/22/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 S COULTER ST STE B
AMARILLO TX
79106-0703
US

IV. Provider business mailing address

8410 W LOOP 335 S
AMARILLO TX
79119-7465
US

V. Phone/Fax

Practice location:
  • Phone: 806-356-0080
  • Fax:
Mailing address:
  • Phone: 830-456-3637
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. KENT WEINHEIMER
Title or Position: MD/OWNER
Credential:
Phone: 830-456-3637