Provider Demographics
NPI:1942526892
Name:WEAVER, MARIA-RAQUEL (MD)
Entity Type:Individual
Prefix:
First Name:MARIA-RAQUEL
Middle Name:
Last Name:WEAVER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:9330 LBJ FWY STE 800
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75243-4310
Mailing Address - Country:US
Mailing Address - Phone:972-792-5700
Mailing Address - Fax:214-506-1170
Practice Address - Street 1:12500 LEBANON RD STE 103
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75035-9474
Practice Address - Country:US
Practice Address - Phone:214-297-0297
Practice Address - Fax:214-297-0298
Is Sole Proprietor?:No
Enumeration Date:2010-04-18
Last Update Date:2022-10-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXP4833207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX311158YK6JMedicare PIN