Basic Information
| Provider Information | |||||||||
| NPI: | 1386879963 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WEBER | ||||||||
| FirstName: | PAUL | ||||||||
| MiddleName: | H. | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | BC-HIS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2001 E LOHMAN AVE STE 134 | ||||||||
| Address2: | |||||||||
| City: | LAS CRUCES | ||||||||
| State: | NM | ||||||||
| PostalCode: | 880013196 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5755230267 | ||||||||
| FaxNumber: | 5755236408 | ||||||||
| Practice Location | |||||||||
| Address1: | 2001 E LOHMAN AVE STE 134 | ||||||||
| Address2: | |||||||||
| City: | LAS CRUCES | ||||||||
| State: | NM | ||||||||
| PostalCode: | 880013196 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5755230267 | ||||||||
| FaxNumber: | 5755236408 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/26/2009 | ||||||||
| LastUpdateDate: | 05/26/2009 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 237700000X | 311 | NM | Y | Speech, Language and Hearing Service Providers | Hearing Instrument Specialist | 237700000X | 50058 | TX | N | Speech, Language and Hearing Service Providers | Hearing Instrument Specialist | 237700000X | 1283 | AZ | N | Speech, Language and Hearing Service Providers | Hearing Instrument Specialist |
No ID Information.