MEDICARE: MS. EFFIE DAVIS WEIR BSN-RN

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	163WC0400X	Case Management Registered Nurse	458139	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	100-10702	OTHER	TX	THERAPIST
2	270132725	OTHER	TX	IRS

General Provider Information

NPI Number	:	1538207139
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. EFFIE DAVIS WEIR BSN-RN

Provider Business Mailing Address
First Line	:	2470 GRAY FALLS DR STE 250
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77077-6514
Country	:	US
Telephone Number	:	832-889-8929
Fax Number	:	713-977-1412

Provider Business Practice Location Address
First Line	:	2470 GRAY FALLS DR STE 250
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77077-6514
Country	:	US
Telephone Number	:	832-889-8929
Fax Number	:	713-977-1412

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

Provider Enumeration Date	:	02/03/2007
Last Update Date	:	08/09/2024

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