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NPI Code Detail

MEDICARE: DR. DAVID RANDOLPH WELDON M.D.

MEDICARE: DR. DAVID RANDOLPH WELDON 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
1207K00000XAllergy & Immunology PhysicianG8497TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
184E430OTHERTXBLUE SHIELD

General Provider Information

NPI Number : 1619939527
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DAVID RANDOLPH WELDON M.D.
Provider Business Mailing Address
First Line : PO BOX 844658
Second Line :
City : DALLAS
State : TX
Zip : 75284-4658
Country : US
Telephone Number : 254-724-2111
Fax Number :
Provider Business Practice Location Address
First Line : 900 SCOTT AND WHITE DR
Second Line :
City : COLLEGE STATION
State : TX
Zip : 77845-6419
Country : US
Telephone Number : 979-207-7400
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/05/2006
Last Update Date : 07/23/2025

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