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General NPI Number Information
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NPI Number | 1548308968
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Entity Type | Individual
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Provider Name | DAVID ALLEN WEISSENBURGER PH.D.
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Gender | Male
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Dates
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Enumeration Date | 02/01/2007
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Last Update Date | 01/19/2012
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Provider Practice Location Address
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Address Line | 9219 HANGING MOSS DR
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City | GRANBURY
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State | TX
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Zip | 76049-4117
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Country | US
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Telephone | 254-368-8846
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Fax |
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Provider Business Mailing Address
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Address Line | 9219 HANGING MOSS DR
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City | GRANBURY
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State | TX
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Zip | 76049-4117
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Country | US
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Telephone |
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Fax |
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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 | 103TB0200X
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Taxonomy Name | Cognitive & Behavioral Psychologist
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License Number | 11778
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 103TM1800X
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Taxonomy Name | Intellectual & Developmental Disabilities Psychologist
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License Number | 11778
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License Number State | TX
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