Provider Demographics
NPI:1922608702
Name:WEBER, HEATHER ADELE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:HEATHER
Middle Name:ADELE
Last Name:WEBER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:236 SUNDAY CIR
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78624-9550
Mailing Address - Country:US
Mailing Address - Phone:512-749-6648
Mailing Address - Fax:830-990-0646
Practice Address - Street 1:1435 E MAIN ST
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:TX
Practice Address - Zip Code:78624-5273
Practice Address - Country:US
Practice Address - Phone:830-997-3047
Practice Address - Fax:830-990-0646
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-29
Last Update Date:2020-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX51716183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist