MEDICARE: MS. WENDY ROBIN WEIR LIC. AC.

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
1	171100000X	Acupuncturist	AC01363	TX

General Provider Information

NPI Number	:	1366780611
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. WENDY ROBIN WEIR LIC. AC.

Provider Business Mailing Address
First Line	:	5092 RUBY MINE RD
Second Line	:
City	:	LAS CRUCES
State	:	NM
Zip	:	88011-9320
Country	:	US
Telephone Number	:	575-650-7543
Fax Number	:

Provider Business Practice Location Address
First Line	:	1417 BROWN ST
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79902-4752
Country	:	US
Telephone Number	:	915-533-2225
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/22/2013
Last Update Date	:	01/22/2013

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