Healthcare Provider Details

I. General information

NPI: 1053755454
Provider Name (Legal Business Name): WILLIAM MICHAEL WEISS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/29/2013
Last Update Date: 08/26/2025
Certification Date: 08/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 UNIVERSITY BLVD.
GALVESTON TX
77555-0165
US

IV. Provider business mailing address

301 UNIVERSITY BLVD.
GALVESTON TX
77555-0165
US

V. Phone/Fax

Practice location:
  • Phone: 832-505-1200
  • Fax: 281-309-0137
Mailing address:
  • Phone: 409-747-5701
  • Fax: 409-747-5715

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License NumberP9133
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberP9133
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: