Healthcare Provider Details

I. General information

NPI: 1386177822
Provider Name (Legal Business Name): COURTNEY R WEBER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/11/2017
Last Update Date: 08/12/2024
Certification Date: 08/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1010 W 40TH ST
AUSTIN TX
78756-4010
US

IV. Provider business mailing address

1431 SW 1ST AVE BITZER BLDG. SUITE 7
OCALA FL
34471-6500
US

V. Phone/Fax

Practice location:
  • Phone: 512-459-8753
  • Fax: 866-591-1084
Mailing address:
  • Phone: 352-401-1425
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License NumberV2851
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: