Healthcare Provider Details

I. General information

NPI: 1346363280
Provider Name (Legal Business Name): ADAM BRYCE WEINFELD M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/07/2007
Last Update Date: 12/27/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 N IH 35, STE 320
AUSTIN TX
78701
US

IV. Provider business mailing address

1400 N IH 35, STE 320
AUSTIN TX
78701
US

V. Phone/Fax

Practice location:
  • Phone: 512-324-8320
  • Fax: 512-324-8326
Mailing address:
  • Phone: 512-324-8320
  • Fax: 512-324-8326

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0122X
TaxonomyPlastic and Reconstructive Surgery Physician
License NumberM7747
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: