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General NPI Number Information
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NPI Number | 1215948658
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Entity Type | Organization
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Legal Business Name | MITCH WEAVER AND ASSOCIATES, LLC
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Dates
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Enumeration Date | 08/10/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 6719A FAIRMONT PKWY
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City | PASADENA
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State | TX
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Zip | 77505-4403
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Country | US
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Telephone | 281-991-3002
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Fax | 281-991-3022
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Provider Business Mailing Address
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Address Line | 6719A FAIRMONT PKWY
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City | PASADENA
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State | TX
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Zip | 77505-4403
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Country | US
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Telephone | 281-991-3002
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Fax | 281-991-3022
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MITCHELL BRIAN WEAVER
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Credential | D.C.
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Telephone | 281-991-3002
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 9984
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License Number State | TX
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