Provider Demographics
NPI:1134602444
Name:WEISS, KURT DENNIS (LVN)
Entity type:Individual
Prefix:MR
First Name:KURT
Middle Name:DENNIS
Last Name:WEISS
Suffix:
Gender:M
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9220 GRAPE AVE
Mailing Address - Street 2:
Mailing Address - City:FRANKSTON
Mailing Address - State:TX
Mailing Address - Zip Code:75763-4314
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9220 GRAPE AVE
Practice Address - Street 2:
Practice Address - City:FRANKSTON
Practice Address - State:TX
Practice Address - Zip Code:75763-4314
Practice Address - Country:US
Practice Address - Phone:903-752-1083
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-12
Last Update Date:2018-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX303751164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse