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Organization
JENNIFER WEATHERLY, D.O. P.A
Active
Organization
JENNIFER WEATHERLY, D.O. P.A
Active
Other names
Grandview Medical Center
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER ANDREA WEATHERLY D.O. (PHYSICIAN/OWNER)
(972) 274-5200
Entity
Organization
Contact information
Practice address
3250 W PLEASANT RUN RD STE 160, LANCASTER, TX 75146-1071
(972) 274-5200
(972) 274-5217
Mailing address
3250 W PLEASANT RUN RD STE 160, LANCASTER, TX 75146-1071
(972) 274-5200
(972) 274-5217
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0076KT
BCBS
TX
Enumeration date
08/08/2006
Last updated
02/10/2014
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