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General NPI Number Information
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NPI Number | 1871525501
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Entity Type | Individual
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Provider Name | MITCHELL BRIAN WEAVER D.C.
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Gender | Male
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Dates
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Enumeration Date | 07/06/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 6719A FAIRMONT PKWY
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City | PASADENA
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State | TX
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Zip | 77505-4403
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Country | US
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Telephone | 281-991-3002
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Fax | 281-991-3022
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Provider Business Mailing Address
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Address Line | 2513 LAKESIDE LNDG
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City | SEABROOK
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State | TX
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Zip | 77586-8312
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Country | US
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Telephone | 281-991-3002
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Fax | 281-991-3022
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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 | 9984
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License Number State | TX
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