Individual
ELIZABETH A TRACEY WEAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
WHNP
Contact information
Practice address
1250 8TH AVENUE, SUITE 330, FORT WORTH, TX 76104
(817) 923-5559
(817) 924-3222
Mailing address
PO BOX 961205, FORT WORTH, TX 76161-1205
(817) 740-8400
(817) 924-3222
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
569928
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
172840401
—
TX
01
—
P00791937
RAILROAD MEDICARE
TX
Enumeration date
07/17/2006
Last updated
03/17/2010
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