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Individual

MATTHEW GARRETT WEAVER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
1502 E 17TH ST, SWEETWATER, TX 79556-1734
(325) 721-7416
(325) 235-1701
Mailing address
4100 INTERNATIONAL PLAZA, SUITE 600, FORT WORTH, TX 76109
(817) 224-0530
(817) 877-0350

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
671037
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
072555
CRNA CERTIFICATION
TX
01
671037
LICENSE #
TX
Enumeration date
08/15/2007
Last updated
08/10/2011
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