Provider Demographics
NPI:1265404248
Name:WEINMAN, JANICE VLASAK (DDS)
Entity type:Individual
Prefix:DR
First Name:JANICE
Middle Name:VLASAK
Last Name:WEINMAN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1460 EASTWOOD DR.
Mailing Address - Street 2:
Mailing Address - City:SEGUIN
Mailing Address - State:TX
Mailing Address - Zip Code:78155-5216
Mailing Address - Country:US
Mailing Address - Phone:830-372-2949
Mailing Address - Fax:830-372-3636
Practice Address - Street 1:1460 EASTWOOD DR.
Practice Address - Street 2:
Practice Address - City:SEGUIN
Practice Address - State:TX
Practice Address - Zip Code:78155-5216
Practice Address - Country:US
Practice Address - Phone:830-372-2949
Practice Address - Fax:830-372-3636
Is Sole Proprietor?:No
Enumeration Date:2006-02-03
Last Update Date:2015-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15680122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX815633OtherUNITED CONCORDIA
TX120832402Medicaid