Provider Demographics
NPI:1215948658
Name:MITCH WEAVER AND ASSOCIATES, LLC
Entity type:Organization
Organization Name:MITCH WEAVER AND ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MITCHELL
Authorized Official - Middle Name:BRIAN
Authorized Official - Last Name:WEAVER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:281-991-3002
Mailing Address - Street 1:6719A FAIRMONT PKWY
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:TX
Mailing Address - Zip Code:77505-4403
Mailing Address - Country:US
Mailing Address - Phone:281-991-3002
Mailing Address - Fax:281-991-3022
Practice Address - Street 1:6719A FAIRMONT PKWY
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:TX
Practice Address - Zip Code:77505-4403
Practice Address - Country:US
Practice Address - Phone:281-991-3002
Practice Address - Fax:281-991-3022
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9984111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty