Provider Demographics
NPI:1205108214
Name:WEAVER, SHAJUIET
Entity type:Individual
Prefix:
First Name:SHAJUIET
Middle Name:
Last Name:WEAVER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5821 SOUTHWEST FWY STE 204
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77057-7501
Mailing Address - Country:US
Mailing Address - Phone:713-592-6188
Mailing Address - Fax:713-592-6211
Practice Address - Street 1:5821 SOUTHWEST FWY STE 204
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77057-7501
Practice Address - Country:US
Practice Address - Phone:713-592-6188
Practice Address - Fax:713-592-6211
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-07
Last Update Date:2012-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy