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Organization
JENNIFER WEATHERLY, D.O., P.A.
Active
Organization
JENNIFER WEATHERLY, D.O., P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TAMMY WALKER (OFFICE MANAGER)
(972) 274-5200
Entity
Organization
Contact information
Practice address
3250 W PLEASANT RUN RD, 160, LANCASTER, TX 75146-1050
(972) 274-5200
(972) 274-5217
Mailing address
3250 W PLEASANT RUN RD, 160, LANCASTER, TX 75146-1050
(972) 274-5200
(972) 274-5217
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
L3871
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
L3871
LICENSE
TX
Enumeration date
10/17/2011
Last updated
10/17/2011
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