MEDICARE: WESTON PRICE SCOTT M.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
1	207Q00000X	Family Medicine Physician	H5054	TX

General Provider Information

NPI Number	:	1538461504
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WESTON PRICE SCOTT M.D.

Provider Business Mailing Address
First Line	:	8431 FREDERICKSBURG RD
Second Line	:	460
City	:	SAN ANTONIO
State	:	TX
Zip	:	78229-3392
Country	:	US
Telephone Number	:	210-617-1830
Fax Number	:	210-617-1050

Provider Business Practice Location Address
First Line	:	8431 FREDERICKSBURG RD
Second Line	:	460
City	:	SAN ANTONIO
State	:	TX
Zip	:	78229-3392
Country	:	US
Telephone Number	:	210-617-1830
Fax Number	:	210-617-1050

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

Provider Enumeration Date	:	11/24/2010
Last Update Date	:	11/24/2010

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