Provider Demographics
NPI:1063514768
Name:WEBER, RICHARD THORP JR (DDS)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:THORP
Last Name:WEBER
Suffix:JR
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1301 W 38TH ST
Mailing Address - Street 2:SUITE 708
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78705-1016
Mailing Address - Country:US
Mailing Address - Phone:512-452-4495
Mailing Address - Fax:512-206-0865
Practice Address - Street 1:1301 W 38TH ST
Practice Address - Street 2:SUITE 708
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78705-1016
Practice Address - Country:US
Practice Address - Phone:512-452-4495
Practice Address - Fax:512-206-0865
Is Sole Proprietor?:No
Enumeration Date:2006-09-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX91331223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice