Basic Information
| Provider Information | |||||||||
| NPI: | 1538206313 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CAROL WEIDNER, M.D., P.A. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4275 LITTLE RD | ||||||||
| Address2: | SUITE 202 | ||||||||
| City: | ARLINGTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 760165600 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8175168811 | ||||||||
| FaxNumber: | 8175168444 | ||||||||
| Practice Location | |||||||||
| Address1: | 4275 LITTLE RD | ||||||||
| Address2: | SUITE 202 | ||||||||
| City: | ARLINGTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 760165600 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8175168811 | ||||||||
| FaxNumber: | 8175168444 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/31/2007 | ||||||||
| LastUpdateDate: | 01/22/2008 | ||||||||
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| AuthorizedOfficialLastName: | WEIDNER | ||||||||
| AuthorizedOfficialFirstName: | CAROL | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 8175168111 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207LP2900X | J0876 | TX | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Anesthesiology | Pain Medicine |
No ID Information.