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NPI Code Detail

MEDICARE: WEAVER WELLNESS CENTER INC

MEDICARE: WEAVER WELLNESS CENTER INC
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
1261QM1300XMulti-Specialty Clinic/Center

General Provider Information

NPI Number : 1538744149
Entity Type Code : Organization
Provider Name (Legal Business Name) : WEAVER WELLNESS CENTER INC
Provider Business Mailing Address
First Line : 926 N WILCREST DR STE 100
Second Line :
City : HOUSTON
State : TX
Zip : 77079-3504
Country : US
Telephone Number : 936-314-7701
Fax Number :
Provider Business Practice Location Address
First Line : 926 N WILCREST DR
Second Line :
City : HOUSTON
State : TX
Zip : 77079-3504
Country : US
Telephone Number : 936-314-7701
Fax Number :
Authorized Official
Title or Position : CEO
Name : MICKEY WEAVER
Credential :
Telephone Number : 936-314-7701
Provider Enumeration Date : 03/15/2021
Last Update Date : 11/02/2021

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Directions to “WEAVER WELLNESS CENTER INC ” Practice Location

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