Wea Medical Group, PLLC

Primary specialty

Public Health & General Preventive Medicine PhysicianTaxonomy code 2083P0901X

Legal business name

WEA MEDICAL GROUP, PLLC

Doing business as

Wellness and Equity Alliance

Practice address

1709 Drake Ave
Austin, TX 78704-3526

Phone

(770) 833-7391

NPI assigned

Jan 13, 2022

Last updated

Apr 18, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Harrison Lobdell IV, MD

Title

Chief Medical Officer

Phone

(770) 833-7391

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Wellness and Equity Alliance Doing business as

Locations

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

{
    "created_epoch": "1642032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1650240000000",
    "number": "1891446605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1709 DRAKE AVE",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787043526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1709 DRAKE AVE",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787043526",
            "telephone_number": "770-833-7391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEA MEDICAL GROUP, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-13",
        "last_updated": "2022-04-18",
        "certification_date": "2022-04-18",
        "status": "A",
        "authorized_official_last_name": "LOBDELL",
        "authorized_official_first_name": "HARRISON",
        "authorized_official_title_or_position": "CHIEF MEDICAL OFFICER",
        "authorized_official_telephone_number": "770-833-7391",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "IV",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2083P0901X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Public Health & General Preventive Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4261893",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wellness and Equity Alliance",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Public Health & General Preventive Medicine Physician in Austin, TX
• Providers in Austin, TX by specialty
• Public Health & General Preventive Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 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.