Provider Demographics
NPI:1801997614
Name:WEISS, MICHAEL (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:
Last Name:WEISS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:9101 LBJ FWY
Mailing Address - Street 2:STE 760
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75243-2057
Mailing Address - Country:US
Mailing Address - Phone:972-792-5700
Mailing Address - Fax:214-506-1170
Practice Address - Street 1:9101 LBJ FWY
Practice Address - Street 2:STE 760
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75243-2057
Practice Address - Country:US
Practice Address - Phone:972-792-5700
Practice Address - Fax:214-506-1170
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2017-04-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY239157207L00000X
TXQ7809207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXQ7809OtherTX MEDICAL LICENSE