Provider Demographics
NPI:1205406766
Name:WEIS, JESSICA L (OD)
Entity type:Individual
Prefix:MISS
First Name:JESSICA
Middle Name:L
Last Name:WEIS
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Gender:F
Credentials:OD
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Mailing Address - Street 1:12101 WOODCREST EXECUTIVE DR STE 150
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63141-5050
Mailing Address - Country:US
Mailing Address - Phone:314-921-2020
Mailing Address - Fax:314-863-9977
Practice Address - Street 1:12101 WOODCREST EXECUTIVE DR STE 150
Practice Address - Street 2:
Practice Address - City:CREVE COEUR
Practice Address - State:MO
Practice Address - Zip Code:63141-5050
Practice Address - Country:US
Practice Address - Phone:314-863-9966
Practice Address - Fax:314-863-9977
Is Sole Proprietor?:No
Enumeration Date:2021-06-28
Last Update Date:2024-04-29
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Provider Licenses
StateLicense IDTaxonomies
MO2021023744152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management