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General NPI Number Information
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NPI Number | 1679386601
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Entity Type | Individual
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Provider Name | COLBY BLAIN WEIKERT
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Gender | Male
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Dates
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Enumeration Date | 01/31/2025
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Last Update Date | 01/31/2025
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Provider Practice Location Address
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Address Line | 150 BRAND STE 700
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City | MURPHY
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State | TX
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Zip | 75094-3734
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Country | US
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Telephone | 469-445-2445
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Fax |
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Provider Business Mailing Address
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Address Line | 24120 OSCAR RD
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City | SPICEWOOD
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State | TX
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Zip | 78669-2622
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Country | US
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Telephone | 208-971-4383
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number |
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License Number State |
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