Healthcare Provider Details
I. General information
NPI: 1669395000
Provider Name (Legal Business Name): PAULLA WEEKES LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 08/03/2026
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2900 E 29TH ST
BRYAN TX
77802-2622
US
IV. Provider business mailing address
1610 W 5TH ST
CALDWELL TX
77836-1379
US
V. Phone/Fax
- Phone: 979-436-9165
- Fax:
- Phone: 631-332-5364
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 104100000X |
| Taxonomy | Social Worker |
| License Number | 116313 |
| License Number State | TX |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: