Individual
MR. MIKE WEAVER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CTRS
Contact information
Practice address
1901 VETERANS MEMORIAL DR, TEMPLE, TX 76504-7451
(254) 778-4811
Mailing address
2675 CLOISTERS DR, COLLEGE STATION, TX 77845-7694
(979) 739-7263
Taxonomy
Speciality
Code
Description
License number
State
273R00000X
Psychiatric Hospital Unit
Primary
—
—
273Y00000X
Rehabilitation Hospital Unit
—
—
276400000X
Substance Use Disorder Rehabilitation Hospital Unit
—
—
Other
Enumeration date
08/01/2006
Last updated
09/04/2009
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