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Individual

BEVERLY CATHERINE WEICKGENANT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
12221 MERIT DR, SUITE 1500, DALLAS, TX 75251-2202
(214) 217-1911
(214) 217-1901
Mailing address
12221 MERIT DR, SUITE 1500, DALLAS, TX 75251-2202

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1131172
NCCPA
TX
Enumeration date
02/24/2016
Last updated
02/24/2016
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