Provider Demographics
NPI:1689052805
Name:MJ WEAVER CORP
Entity Type:Organization
Organization Name:MJ WEAVER CORP
Other - Org Name:SYNERGY HOMECARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:
Authorized Official - Last Name:WEAVER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-514-1208
Mailing Address - Street 1:8402 STERLING ST STE 103
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75063-2566
Mailing Address - Country:US
Mailing Address - Phone:972-514-1208
Mailing Address - Fax:
Practice Address - Street 1:8402 STERLING ST STE 103
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75063-2566
Practice Address - Country:US
Practice Address - Phone:972-514-1208
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-07
Last Update Date:2015-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care