Provider Demographics
NPI:1881858744
Name:WEAVER, BROOKE JEMELKA (MD)
Entity Type:Individual
Prefix:
First Name:BROOKE
Middle Name:JEMELKA
Last Name:WEAVER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1327 LAKE POINTE PKWY
Mailing Address - Street 2:SUITE 410
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-4095
Mailing Address - Country:US
Mailing Address - Phone:281-637-9095
Mailing Address - Fax:
Practice Address - Street 1:1327 LAKE POINTE PKWY STE 500
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-4096
Practice Address - Country:US
Practice Address - Phone:281-637-9095
Practice Address - Fax:713-383-1502
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-10
Last Update Date:2021-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2008018596207V00000X
NE26566207V00000X
TXP6836207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology