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NPI Code Detail

MEDICARE: GARTH B WEAVER O.D.

MEDICARE: GARTH B WEAVER O.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1152WC0802XCorneal and Contact Management Optometrist2900TGTX

General Provider Information

NPI Number : 1306880059
Entity Type Code : Individual
Provider Name (Legal Business Name) : GARTH B WEAVER O.D.
Provider Business Mailing Address
First Line : 2509 CRYSTAL BEND DR
Second Line :
City : PFLUGERVILLE
State : TX
Zip : 78660-8304
Country : US
Telephone Number : 512-252-8717
Fax Number :
Provider Business Practice Location Address
First Line : 3908 FAR WEST BLVD
Second Line :
City : AUSTIN
State : TX
Zip : 78731-2994
Country : US
Telephone Number : 512-343-0432
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/15/2006
Last Update Date : 09/13/2012

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Directions to “ GARTH B WEAVER O.D.” Practice Location

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