Individual
KEVIN L. WEAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6606 LBJ FWY, SUITE 200, DALLAS, TX 75240-6533
(972) 715-5000
(972) 715-9976
Mailing address
PO BOX 650865, DALLAS, TX 75265-0865
(972) 715-5000
(972) 715-9976
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
K5024
TX
207L00000X
Anesthesiology Physician
Primary
K5024
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
042685003
—
TX
01
—
8EH634
BCBS
TX
01
—
P01446908
RR
TX
Enumeration date
06/05/2006
Last updated
11/03/2015
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