Provider Demographics
NPI:1669468633
Name:CHUANG, WEBER W (MD)
Entity Type:Individual
Prefix:
First Name:WEBER
Middle Name:W
Last Name:CHUANG
Suffix:
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 1:5001 S COOPER ST STE 201
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76017-5993
Mailing Address - Country:US
Mailing Address - Phone:866-367-8768
Mailing Address - Fax:817-541-9555
Practice Address - Street 1:5005 S COOPER ST STE 250
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76017
Practice Address - Country:US
Practice Address - Phone:866-367-8768
Practice Address - Fax:817-541-9540
Is Sole Proprietor?:No
Enumeration Date:2005-09-23
Last Update Date:2020-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL9144208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX168235301MedicaidDALLAS
TX168235304Medicaid
TX168235305OtherMEDICAID OTHER
TX168235302MedicaidTARRANT
TX168235303MedicaidOTHER
TX168235306Medicaid
TX168235306Medicaid
TXTXB120454Medicare PIN
TX168235305OtherMEDICAID OTHER
TX168235301MedicaidDALLAS