Healthcare Provider Details

I. General information

NPI: 1720395064
Provider Name (Legal Business Name): ROBERT ANTHONY WEAVER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/08/2010
Last Update Date: 09/08/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9432 KATY FREEWAY SUITE 200
HOUSTON TX
77055-6349
US

IV. Provider business mailing address

9432 KATY FREEWAY SUITE 200
HOUSTON TX
77055-6349
US

V. Phone/Fax

Practice location:
  • Phone: 713-335-5671
  • Fax: 713-935-0649
Mailing address:
  • Phone: 713-335-5671
  • Fax: 713-935-0649

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License NumberH6694
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: