Organization
KINGWOOD DIRECT MD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHAUN WEAVER MD (OWNER)
(832) 445-5641
Entity
Organization
Contact information
Practice address
24 N MAIN ST, KINGWOOD, TX 77339-3709
(281) 570-6758
(832) 777-6282
Mailing address
24 N MAIN ST, KINGWOOD, TX 77339-3709
(281) 570-6758
(832) 777-6282
Taxonomy
Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
—
—
Other
Enumeration date
11/01/2018
Last updated
11/01/2018
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