Provider Demographics
NPI:1295063121
Name:WEAVER, STEPHANIE MEI LI (PHARMD)
Entity type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:MEI LI
Last Name:WEAVER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1920 E RIVERSIDE DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78741-1342
Mailing Address - Country:US
Mailing Address - Phone:512-326-5228
Mailing Address - Fax:512-326-1733
Practice Address - Street 1:5819 BURNET RD
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78756-1114
Practice Address - Country:US
Practice Address - Phone:512-687-2212
Practice Address - Fax:512-687-2218
Is Sole Proprietor?:No
Enumeration Date:2009-12-04
Last Update Date:2015-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX46365183500000X
GA26995183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist