Individual
HARRY TALMADGE WEAVER JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1804 COLLEGE AVE, LEVELLAND, TX 79336-6507
(806) 894-3141
Mailing address
3420 22ND PL, LUBBOCK, TX 79410-1314
(806) 725-5844
(806) 723-6532
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
H4784
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00J33Z
BLUE CROSS BLUE SHIELD
TX
01
—
119654
SUPERIOR HEALTH PLAN
TX
01
—
126521102
FIRSTCARE
TX
05
—
131443702
—
TX
01
—
1416698
FIRST HEALTH CCN
—
01
—
4365823
AETNA
—
Enumeration date
10/13/2005
Last updated
07/30/2013
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