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Individual

DR. DAVID G. VANDERWEIDE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
12827 GULF FWY, HOUSTON, TX 77034-4807
(281) 481-2649
(281) 481-0080
Mailing address
12827 GULF FWY, HOUSTON, TX 77034-4807
(281) 481-2649
(281) 481-0080

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
H5811
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1578600813
GROUP NPI
TX
01
328385500
DOL
TX
01
43KZ
GROUP BCBS
TX
01
8K9510
VANDERWEIDE BCBS
TX
01
P00109362
MEDICARE RAILROAD PROV. #
TX
Enumeration date
08/03/2006
Last updated
12/18/2007
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