Provider Demographics
NPI:1194829267
Name:WIER, JOHN REX III (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:REX
Last Name:WIER
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3724 JEFFERSON ST
Mailing Address - Street 2:STE 111
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78731-6219
Mailing Address - Country:US
Mailing Address - Phone:512-452-0109
Mailing Address - Fax:512-452-2706
Practice Address - Street 1:3724 JEFFERSON ST
Practice Address - Street 2:STE 111
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78731-6219
Practice Address - Country:US
Practice Address - Phone:512-452-0109
Practice Address - Fax:512-452-2706
Is Sole Proprietor?:No
Enumeration Date:2006-09-11
Last Update Date:2007-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist