Provider Demographics
NPI:1386879963
Name:WEBER, PAUL H (BC-HIS)
Entity type:Individual
Prefix:MR
First Name:PAUL
Middle Name:H
Last Name:WEBER
Suffix:
Gender:M
Credentials:BC-HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2001 E LOHMAN AVE STE 134
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88001-3196
Mailing Address - Country:US
Mailing Address - Phone:575-523-0267
Mailing Address - Fax:575-523-6408
Practice Address - Street 1:2001 E LOHMAN AVE STE 134
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88001-3196
Practice Address - Country:US
Practice Address - Phone:575-523-0267
Practice Address - Fax:575-523-6408
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-26
Last Update Date:2009-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM311237700000X
TX50058237700000X
AZ1283237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist