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General NPI Number Information
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NPI Number | 1366688251
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Entity Type | Individual
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Provider Name | MR. JOSEPH D WEAVER
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Gender | Male
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Dates
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Enumeration Date | 12/23/2008
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Last Update Date | 12/23/2008
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Provider Practice Location Address
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Address Line | 205 W EDINBURG AVE
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City | ELSA
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State | TX
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Zip | 78543-1769
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Country | US
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Telephone | 956-262-1037
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Fax | 956-262-7756
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Provider Business Mailing Address
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Address Line | 120 W JONES ST
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City | PHARR
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State | TX
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Zip | 78577-5336
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Country | US
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Telephone | 956-783-5318
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Fax | 956-262-7756
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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 | 2355S0801X
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Taxonomy Name | Speech-Language Assistant
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License Number | 34640
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License Number State | TX
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