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General NPI Number Information
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NPI Number | 1700010790
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Entity Type | Organization
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Legal Business Name | LISA L. WEAVER, PH.D., P.C.
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Dates
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Enumeration Date | 05/06/2009
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Last Update Date | 05/06/2009
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Provider Practice Location Address
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Address Line | 701 N. POST OAK DR. SUITE 320
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City | HOUSTON
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State | TX
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Zip | 77024-3871
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Country | US
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Telephone | 713-781-2220
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Fax | 713-688-0101
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Provider Business Mailing Address
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Address Line | 701 N POST OAK DR. SUITE 320
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City | HOUSTON
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State | TX
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Zip | 77024-3839
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Country | US
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Telephone | 713-781-2220
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Fax | 713-688-0101
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Authorized Official
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Title or Position | BUSINESS OFFICE
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Name | DWIGHT F YODERS
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Credential |
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Telephone | 281-429-2300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 23812
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License Number State | TX
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