Individual
HAROLD GORDON WEEMS JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2602 SAINT MICHAEL DR STE 302A, TEXARKANA, TX 75503-2387
(903) 614-5016
Mailing address
2900 SAINT MICHAEL DR STE 401, TEXARKANA, TX 75503-5211
(903) 614-5383
(903) 614-5343
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
E2229
AR
207X00000X
Orthopaedic Surgery Physician
Primary
J6798
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
132097004
—
TX
05
—
132097008
—
TX
05
—
136778001
—
AR
01
—
1G2223
MEDICARE
TX
05
—
200241380B
—
OK
01
—
98164
BCBS
—
01
—
P02599448
RR MCR
TX
Enumeration date
07/29/2005
Last updated
06/23/2021
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