Provider Demographics
NPI:1487979308
Name:WEGER, LEWIS CHARLES (PA-C)
Entity type:Individual
Prefix:
First Name:LEWIS
Middle Name:CHARLES
Last Name:WEGER
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:7600 W MILE 8 RD
Mailing Address - Street 2:
Mailing Address - City:MISSION
Mailing Address - State:TX
Mailing Address - Zip Code:78574-4401
Mailing Address - Country:US
Mailing Address - Phone:956-519-1344
Mailing Address - Fax:956-519-1344
Practice Address - Street 1:2308 HIGHWAY 83 STE F
Practice Address - Street 2:
Practice Address - City:PENITAS
Practice Address - State:TX
Practice Address - Zip Code:78576-8399
Practice Address - Country:US
Practice Address - Phone:956-519-9100
Practice Address - Fax:956-519-9900
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-03
Last Update Date:2010-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA03253363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical