Healthcare Provider Details

I. General information

NPI: 1003867391
Provider Name (Legal Business Name): JOSHUA L. WEISS, MD, ASSOCIATED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/12/2006
Last Update Date: 11/16/2022
Certification Date: 11/16/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12201 MERIT DR STE 325
DALLAS TX
75251-3140
US

IV. Provider business mailing address

12201 MERIT DR STE 325
DALLAS TX
75251-3140
US

V. Phone/Fax

Practice location:
  • Phone: 972-619-1800
  • Fax: 972-619-1808
Mailing address:
  • Phone: 972-619-1800
  • Fax: 972-619-1808

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License NumberK4833
License Number StateTX

VIII. Authorized Official

Name: DR. JOSHUA L. WEISS
Title or Position: PRESIDENT
Credential: MD
Phone: 972-619-1800