Verita Juanice Weaver, RN

Individual provider Active NPI Pediatric Neurodevelopmental Disabilities Physician · Purdon, TX

NPI 1407401581 · NPPES record last updated Aug 6, 2019

Key facts

NPI
1407401581
Entity type
Individual (NPI type 1)
Primary specialty
Pediatric Neurodevelopmental Disabilities Physician 2080P0008X
License
925957 (TX)
Practice address
3703 NW County Road 3115
Purdon, TX 76679-3074
Phone
(903) 257-6629
NPI assigned
Aug 6, 2019
Sex
Female
Sole proprietor
Yes

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
925957TXMDPediatric Neurodevelopmental Disabilities Physician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Neurodevelopmental Disabilities Physician 2080P0008X 925957 TX Yes

Addresses

Primary practice location

3703 NW County Road 3115
Purdon, TX 76679-3074

Mailing address

3703 NW County Road 3115
Purdon, TX 76679-3074
Phone (903) 257-6629

Other providers in Purdon, TX

All providers in Purdon, TX · Pediatric Neurodevelopmental Disabilities Physician in Texas

Sources for this page

Verify at the official NPI Registry.