Individual
AMANDA ELIZABETH WEAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2237 S JACKSON ST, SAN ANGELO, TX 76904-5131
(325) 747-1511
Mailing address
2237 S JACKSON ST, SAN ANGELO, TX 76904-5131
(325) 747-1511
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
T6074
TX
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
T6074
TX
Other
Enumeration date
06/09/2020
Last updated
07/16/2024
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