Provider Demographics
NPI:1790765931
Name:WEISS, JOSHUA L (MD)
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:L
Last Name:WEISS
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 1:12201 MERIT DR STE 325
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75251-3140
Mailing Address - Country:US
Mailing Address - Phone:972-619-1800
Mailing Address - Fax:972-619-1808
Practice Address - Street 1:12201 MERIT DR STE 325
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75251-3140
Practice Address - Country:US
Practice Address - Phone:972-619-1800
Practice Address - Fax:972-619-1808
Is Sole Proprietor?:No
Enumeration Date:2006-01-21
Last Update Date:2022-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK4833207VM0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX158029211Medicaid
TX158029203Medicaid
TX158029201Medicaid
TX158029206Medicaid
TX158029212Medicaid
TX158029208Medicaid
TX158029205Medicaid
TX158029210Medicaid