Individual provider Active NPI

Michael Ross Weir, M.D.

  • Pediatrics Physician
  • Temple, TX
National Provider Identifier
1417170275
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
D6624 Issued in TX
Practice address
2516 Canyon Creek Dr
Temple, TX 76502-3105
Phone
(254) 742-2304
Fax
(254) 742-0207
NPI assigned
Apr 10, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X D6624 TX Primary

Addresses

Primary practice location

2516 Canyon Creek Dr
Temple, TX 76502-3105

Mailing address

2516 Canyon Creek Dr
Temple, TX 76502-3105
Phone (254) 742-2304

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
D6624TXMDPediatrics Physician

NPI Registry JSON

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

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1417170275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2516 CANYON CREEK DR",
            "city": "TEMPLE",
            "state": "TX",
            "postal_code": "765023105",
            "telephone_number": "254-742-2304",
            "fax_number": "254-742-0207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2516 CANYON CREEK DR",
            "city": "TEMPLE",
            "state": "TX",
            "postal_code": "765023105",
            "telephone_number": "254-742-2304",
            "fax_number": "254-742-0207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEIR",
        "first_name": "MICHAEL",
        "middle_name": "ROSS",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "D6624",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Temple, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.