Richard E Weaver

NPI #1972896751 in Beaumont, Texas

Provider Information

NPI Number: 1972896751
Entity Type: Organization
Organization Name: Richard E Weaver
Primary Specialty: Dentist - General Practice
Enumeration Date: May 26, 2011
Last Updated: May 26, 2011

Practice Location

Address: 3590 BLACKMON LN
Address 2: #1
City: Beaumont
State: Texas
ZIP Code: 77706-7956
Phone: (409) 898-8602

Authorized Official

Name: MRS. JULIE DEANNE DAVIS
Title: FINANCE MANAGER
Phone: (409) 898-8602

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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