Individual provider Active NPI

Lauren D'Angelo Weaver, MD

  • Neurology with Special Qualifications in Child Neurology Physician
  • Shenandoah, TX
National Provider Identifier
1356603146
Registry record updated Aug 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology with Special Qualifications in Child Neurology PhysicianTaxonomy code 2084N0402X
License
S3611 Issued in TX
Practice address
920 Medical Plaza Dr Ste 120
Shenandoah, TX 77380-3275
Phone
(281) 298-1144
Fax
(281) 298-1133
NPI assigned
Jun 8, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 30, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MT202213 PA
Epilepsy Physician 2084E0001X S3611 TX
Neurology with Special Qualifications in Child Neurology Physician 2084N0402X S3611 TX Primary

Addresses

Primary practice location

920 Medical Plaza Dr Ste 120
Shenandoah, TX 77380-3275

Mailing address

14960 Park Row Dr
Houston, TX 77084-5165
Phone (281) 298-1144

Other identifiers 1

IdentifierTypeStateIssuer
410428301MedicaidTX

Other names 1

  • Lauren D'Angelo Former name

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 Medicine

State licenses

LicenseStateTypeSpecialty
MT202213PAMDPediatrics Physician
S3611TXMDEpilepsy Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Shaun S. Varghese, M.D., PLLC Neurology With Special Qualifications in Child Neurology PastSince Aug 28, 2022 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: lauren.weaver@think.eclinicaldirectplus.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1339113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661817600000",
    "number": "1356603146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14960 PARK ROW DR",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770845165",
            "telephone_number": "281-298-1144",
            "fax_number": "281-298-1133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 MEDICAL PLAZA DR STE 120",
            "city": "SHENANDOAH",
            "state": "TX",
            "postal_code": "773803275",
            "telephone_number": "281-298-1144",
            "fax_number": "281-298-1133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEAVER",
        "first_name": "LAUREN",
        "middle_name": "D'ANGELO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-06-08",
        "last_updated": "2022-08-30",
        "certification_date": "2022-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MT202213",
            "primary": false
        },
        {
            "code": "2084E0001X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Epilepsy",
            "state": "TX",
            "license": "S3611",
            "primary": false
        },
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "TX",
            "license": "S3611",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "410428301",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAUREN",
            "last_name": "D'ANGELO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Shenandoah, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2022; 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.