Individual
EDWARD WEIDOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1200 E BRIN ST, TERRELL, TX 75160-2938
(972) 524-6452
Mailing address
PO BOX 70, TERRELL, TX 75160-9000
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
L5610
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8K5862
MCR B NTSH
TX
Enumeration date
10/04/2006
Last updated
08/12/2010
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