Provider Demographics
NPI:1679570584
Name:WEIDO, ANTHONY J (MD)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:J
Last Name:WEIDO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:7707 FANNIN ST
Mailing Address - Street 2:SUITE 195
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054-1926
Mailing Address - Country:US
Mailing Address - Phone:713-797-0045
Mailing Address - Fax:713-797-1821
Practice Address - Street 1:6243 FAIRMONT PKWY STE 102
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:TX
Practice Address - Zip Code:77505-4046
Practice Address - Country:US
Practice Address - Phone:281-991-6750
Practice Address - Fax:281-991-7611
Is Sole Proprietor?:No
Enumeration Date:2005-07-07
Last Update Date:2022-03-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXJ0350207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
F77339Medicare UPIN
TX84T573Medicare PIN