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General NPI Number Information
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NPI Number | 1649677832
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Entity Type | Individual
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Provider Name | ROBERT PHILLIP WEAVER D.C.
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Gender | Male
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Dates
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Enumeration Date | 12/03/2014
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Last Update Date | 12/03/2014
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Provider Practice Location Address
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Address Line | 10325 LAKE JUNE RD SUITE 110
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City | DALLAS
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State | TX
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Zip | 75217-5312
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Country | US
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Telephone | 972-285-0660
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Fax |
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Provider Business Mailing Address
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Address Line | 1111 S AKARD ST UNIT 408
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City | DALLAS
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State | TX
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Zip | 75215-1020
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Country | US
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Telephone | 505-264-8338
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 12797
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License Number State | TX
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