Provider Demographics
NPI:1417399759
Name:WEINBERG, TARA KATHLEEN (AUD)
Entity Type:Individual
Prefix:DR
First Name:TARA
Middle Name:KATHLEEN
Last Name:WEINBERG
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2821 E PRESIDENT GEORGE BUSH HWY
Mailing Address - Street 2:STE 210
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75082-4266
Mailing Address - Country:US
Mailing Address - Phone:972-867-9135
Mailing Address - Fax:972-612-5048
Practice Address - Street 1:2821 E PRESIDENT GEORGE BUSH HWY
Practice Address - Street 2:STE 210
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75082-4266
Practice Address - Country:US
Practice Address - Phone:972-867-9135
Practice Address - Fax:972-612-5048
Is Sole Proprietor?:No
Enumeration Date:2013-07-29
Last Update Date:2020-12-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX80474231H00000X, 231HA2400X, 237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
No231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No231HA2400XSpeech, Language and Hearing Service ProvidersAudiologistAssistive Technology Practitioner