Provider Demographics
NPI:1346370442
Name:WEBER, KRIS (PHD)
Entity Type:Individual
Prefix:DR
First Name:KRIS
Middle Name:
Last Name:WEBER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7557 RAMBLER RD STE 700
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-2321
Mailing Address - Country:US
Mailing Address - Phone:214-346-6080
Mailing Address - Fax:214-750-8936
Practice Address - Street 1:7557 RAMBLER RD STE 700
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-2321
Practice Address - Country:US
Practice Address - Phone:214-346-6080
Practice Address - Fax:214-750-8936
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-07
Last Update Date:2007-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX25801103G00000X, 103TC0700X, 103TR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TR0400XBehavioral Health & Social Service ProvidersPsychologistRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX6162197OtherUNITED HEALTH CARE
TX2074405OtherCIGNA ID
TX7226254OtherAETNA ID
TX7226254OtherAETNA ID
TX2074405OtherCIGNA ID
TX00234PMedicare ID - Type Unspecified