Individual provider Active NPI

Matthew Randall Weyhe, CNIM

  • Electroneurodiagnostic Specialist/Technologist
  • Dallas, TX
National Provider Identifier
1053633107
Registry record updated Apr 7, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Electroneurodiagnostic Specialist/TechnologistTaxonomy code 246ZE0600X
License
1911 Issued in TX
Practice address
25 Highland Park VLG
Ste 100-225
Dallas, TX 75205-2789
Phone
(214) 536-1647
Fax
(214) 580-7600
NPI assigned
Feb 17, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 7, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Electroneurodiagnostic Specialist/Technologist 246ZE0600X 1911 TX Primary

Addresses

Primary practice location

25 Highland Park VLG
Ste 100-225
Dallas, TX 75205-2789

Mailing address

25 Highland Park VLG
Ste 100-225
Dallas, TX 75205-2789
Phone (214) 536-1647

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)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1266364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491523200000",
    "number": "1053633107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 HIGHLAND PARK VLG",
            "address_2": "STE 100-225",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752052789",
            "telephone_number": "214-536-1647",
            "fax_number": "214-580-7600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 HIGHLAND PARK VLG",
            "address_2": "STE 100-225",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752052789",
            "telephone_number": "214-536-1647",
            "fax_number": "214-580-7600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEYHE",
        "first_name": "MATTHEW",
        "middle_name": "RANDALL",
        "credential": "CNIM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-02-17",
        "last_updated": "2017-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246ZE0600X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Electroneurodiagnostic",
            "state": "TX",
            "license": "1911",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.