Laurence A Weider, M.D.

Primary specialty

Surgery of the Hand (Plastic Surgery) PhysicianTaxonomy code 2082S0105X

License

J4602 Issued in TX

Practice address

7777 Forest LN
Suite B-145
Dallas, TX 75230-2505

Phone

(972) 566-8444

Fax

(972) 566-8453

NPI assigned

Sep 14, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 4

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Laurence Weider MD PA

  • Plastic and Reconstructive Surgery Physician
  • Dallas, TX
  • NPI 1669545331
  NPD (past) Authorized official

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

{
    "created_epoch": "1126656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301356800000",
    "number": "1164417358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7777 FOREST LN",
            "address_2": "SUITE B-145",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752302505",
            "telephone_number": "972-566-8444",
            "fax_number": "972-566-8453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7777 FOREST LN",
            "address_2": "SUITE B-145",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752302505",
            "telephone_number": "972-566-8444",
            "fax_number": "972-566-8453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEIDER",
        "first_name": "LAURENCE",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-14",
        "last_updated": "2011-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2082S0105X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery, Surgery of the Hand",
            "state": "TX",
            "license": "J4602",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OWCP",
            "identifier": "181391100",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "76467",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "030446101",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "50EJ",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Beverly Catherine Weickgenant, PA-C
• Eric Michael Weideman
• Rick Allen Weideman, PHARMD
• Aaron Thomas Weidenaar, PT, DPT
• Sidney Weidenbach, PT, DPT
• Maria Elizabeth Weidmer Mikhail, MD
• Crystalia S. Weidner, PHD, HSPP
• Alan Victor Weier, MD
• Sofia Weigel, MD
• Weight Loss Management LLP

• Surgery of the Hand (Plastic Surgery) Physician in Dallas, TX
• Providers in Dallas, TX by specialty
• Surgery of the Hand (Plastic Surgery) Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.