Provider Demographics
NPI:1932196789
Name:WEILBURG, RICHARD DARO (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:DARO
Last Name:WEILBURG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14405 FM 2093
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78624-7117
Mailing Address - Country:US
Mailing Address - Phone:830-990-4157
Mailing Address - Fax:830-990-4157
Practice Address - Street 1:14405 FM 2093
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:TX
Practice Address - Zip Code:78624-7117
Practice Address - Country:US
Practice Address - Phone:830-990-4157
Practice Address - Fax:830-990-4157
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD-1849207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology