Provider Demographics
NPI:1831827005
Name:DIRBA, WESTON LOUIS
Entity type:Individual
Prefix:
First Name:WESTON
Middle Name:LOUIS
Last Name:DIRBA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12333 ABBEY GDN
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78249-2791
Mailing Address - Country:US
Mailing Address - Phone:979-627-5688
Mailing Address - Fax:
Practice Address - Street 1:11411 BANDERA RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78250-6829
Practice Address - Country:US
Practice Address - Phone:210-507-9148
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-15
Last Update Date:2022-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10616152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist