Ronald Weintraub, M.D.

Individual provider Active NPI Anesthesiology Physician · Groves, TX

NPI 1114004686 · NPPES record last updated Aug 20, 2008

Key facts

NPI
1114004686
Entity type
Individual (NPI type 1)
Primary specialty
Anesthesiology Physician 207L00000X
License
J2998 (TX)
Practice address
5500 39TH St
Groves, TX 77619-2905
Phone
(409) 962-5733
NPI assigned
Nov 1, 2006
Sex
Male
Sole proprietor
No

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine, Physician Assistant

State licenses

LicenseStateTypeSpecialty
J2998TXMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Shreveport Anesthesia Services Anesthesiology Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X J2998 TX Yes

Addresses

Primary practice location

5500 39TH St
Groves, TX 77619-2905

Mailing address

9441 LBJ Fwy Ste 400
Dallas, TX 75243-4500
Phone (972) 664-6963

Other identifiers

IdentifierTypeStateIssuer
J2998OtherLICENSE
127581006MedicaidTX

Other providers in Groves, TX

All providers in Groves, TX · Anesthesiology Physician in Texas

Sources for this page

Verify at the official NPI Registry.