Individual provider Active NPI

Daniel Allan Weidner, DO

  • Emergency Medicine Physician
  • Jbsa Lackland, TX
National Provider Identifier
1003441106
Registry record updated Aug 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
0102206996 Issued in VA
Practice address
1100 Wilford Hall Loop
Jbsa Lackland, TX 78236-5638
Phone
(210) 292-3403
NPI assigned
Mar 9, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 0102206996 VA Primary

Addresses

Primary practice location

1100 Wilford Hall Loop
Jbsa Lackland, TX 78236-5638

Mailing address

1100 Wilford Hall Loop
Jbsa Lackland, TX 78236-5638
Phone (210) 292-3403

Other practice location 1

3551 Roger Brooke Dr
Jbsa Ft Sam Houston, TX 78234-4504
Phone (210) 916-7500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240327001189 TX Practitioner - Emergency Medicine 5799122636 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergency Medicine Services of TX, PLLCGroup PAC ID 3375909351, 374 clinicians

Practice addresses (Care Compare)

20475 Hwy 46 W
Suite 100
Spring Branch, TX 78070-6147
Phone (830) 438-6911

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
0102206996VAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Medicine Services of TX, PLLC Emergency Medicine CurrentSince Nov 15, 2023 Accepting new patients

Locations

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

1020 S State Highway 16
Fredericksburg, TX 78624
Phone (830) 990-1555

225 E Parkwood Ave
Friendswood, TX 77546
Phone (281) 549-9400

12285 Bandera Rd
Helotes, TX 78023
Phone (210) 575-2285

12412 Judson Rd
Live Oak, TX 78233
Phone (210) 646-5000

11100 Shadow Creek Pkwy
Pearland, TX 77584
Phone (713) 770-7000

9211 Potranco Rd
San Antonio, TX 78251
Phone (210) 575-9211

6402 Mallard Mdw
San Antonio, TX 78244
Phone (210) 757-5000

13434 Nacogdoches Rd
San Antonio, TX 78217
Phone (210) 447-7560

1310 McCullough Ave
San Antonio, TX 78212
Phone (210) 208-2200

12805 W Interstate 10
San Antonio, TX 78249
Phone (210) 575-9805

7700 Floyd Curl Dr
San Antonio, TX 78229
Phone (210) 575-5564

20475 State Highway 46 W
Ste 100
Spring Branch, TX 78070
Phone (830) 252-5200

26306 Kuykendahl Rd
Tomball, TX 77375
Phone (346) 246-7700

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1583712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692144000000",
    "number": "1003441106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 WILFORD HALL LOOP",
            "city": "JBSA LACKLAND",
            "state": "TX",
            "postal_code": "782365638",
            "telephone_number": "210-292-3403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 WILFORD HALL LOOP",
            "city": "JBSA LACKLAND",
            "state": "TX",
            "postal_code": "782365638",
            "telephone_number": "210-292-3403"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3551 Roger Brooke Dr",
            "address_purpose": "LOCATION",
            "city": "Jbsa Ft Sam Houston",
            "state": "TX",
            "postal_code": "782344504",
            "country_code": "US",
            "telephone_number": "210-916-7500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WEIDNER",
        "first_name": "DANIEL",
        "middle_name": "ALLAN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-09",
        "last_updated": "2023-08-16",
        "certification_date": "2023-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "VA",
            "license": "0102206996",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jbsa Lackland, TX

Sources for this page

Verify at the official NPI Registry.