MEDICARE: TODD M WEISS 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	207YX0602X	Otolaryngic Allergy Physician	M9091	TX
2	207Y00000X	Otolaryngology Physician	M9091	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	8F8681	OTHER	TX	MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1659593713
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TODD M WEISS M.D.

Provider Business Mailing Address
First Line	:	5641 ESPLANADE DR
Second Line	:
City	:	CORPUS CHRISTI
State	:	TX
Zip	:	78414-4299
Country	:	US
Telephone Number	:	361-287-0100
Fax Number	:	361-287-0101

Provider Business Practice Location Address
First Line	:	5641 ESPLANADE DRIVE
Second Line	:
City	:	CORPUS CHRISTI
State	:	TX
Zip	:	78414-7841
Country	:	US
Telephone Number	:	361-287-0100
Fax Number	:

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

Provider Enumeration Date	:	05/02/2007
Last Update Date	:	11/15/2023

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Directions to “ TODD M WEISS M.D.” Practice Location

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