Active NPI
Edward Weidow, D.O.
- Psychiatry Physician
- Terrell, TX
National Provider Identifier
1033204912
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- L5610
- Practice address
- 1200 E Brin St
Terrell, TX 75160-2938 - Phone
- (972) 524-6452
- NPI assigned
- Oct 4, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | L5610 | TX | Primary |
Addresses
Primary practice location
1200 E Brin St
Terrell, TX 75160-2938
Mailing address
PO Box 70
Terrell, TX 75160-9000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8K5862 | Other | TX | MCR B NTSH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Health and Human Services Commission | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Terrell State Hospital Pharmacy
- Long Term Care Pharmacy
- Terrell, TX
- NPI 1740299775
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159920000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1281571200000",
"number": "1033204912",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 70",
"city": "TERRELL",
"state": "TX",
"postal_code": "751609000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1200 E BRIN ST",
"city": "TERRELL",
"state": "TX",
"postal_code": "751602938",
"telephone_number": "972-524-6452"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WEIDOW",
"first_name": "EDWARD",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-04",
"last_updated": "2010-08-12",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "TX",
"license": "L5610",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MCR B NTSH",
"identifier": "8K5862",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Terrell, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.