Provider Demographics
NPI:1356843247
Name:WEISS, JOEL (RDCS, RDMS, RVT)
Entity type:Individual
Prefix:
First Name:JOEL
Middle Name:
Last Name:WEISS
Suffix:
Gender:M
Credentials:RDCS, RDMS, RVT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1407 REDDEN CV
Mailing Address - Street 2:
Mailing Address - City:CEDAR PARK
Mailing Address - State:TX
Mailing Address - Zip Code:78613-5825
Mailing Address - Country:US
Mailing Address - Phone:512-382-1714
Mailing Address - Fax:
Practice Address - Street 1:1407 REDDEN CV
Practice Address - Street 2:
Practice Address - City:CEDAR PARK
Practice Address - State:TX
Practice Address - Zip Code:78613-5825
Practice Address - Country:US
Practice Address - Phone:512-382-1714
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-06
Last Update Date:2018-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX39922246XC2903X, 246XS1301X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246XS1301XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist CardiovascularSonography
No246XC2903XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist CardiovascularVascular Specialist