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General NPI Number Information
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NPI Number | 1164001236
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Entity Type | Individual
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Provider Name | WESTON VIAL KLOSTER DO
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Gender | Male
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Dates
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Enumeration Date | 04/06/2021
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Last Update Date | 12/04/2025
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Provider Practice Location Address
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Address Line | 280 SMITH AVE N STE 450
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City | SAINT PAUL
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State | MN
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Zip | 55102-2481
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Country | US
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Telephone | 651-241-5959
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Fax | 651-241-5958
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Provider Business Mailing Address
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Address Line | MSC09 5030 1 UNIVERSITY OF NEW MEXICO
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City | ALBUQUERQUE
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State | NM
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Zip | 87131-0001
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Country | US
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Telephone | 505-272-5428
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Fax | 505-272-4639
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State | NM
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 79829
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License Number State | MN
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