Provider Demographics
NPI:1487996773
Name:WEAVER, MATTHEW DAVIS (MD)
Entity type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:DAVIS
Last Name:WEAVER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:MATT
Other - Middle Name:
Other - Last Name:WEAVER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:6560 FANNIN ST STE 1404
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-2706
Mailing Address - Country:US
Mailing Address - Phone:713-790-0600
Mailing Address - Fax:713-790-0616
Practice Address - Street 1:6431 FANNIN ST
Practice Address - Street 2:MSB 4.331
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-1501
Practice Address - Country:US
Practice Address - Phone:713-500-7216
Practice Address - Fax:713-486-0971
Is Sole Proprietor?:No
Enumeration Date:2013-03-25
Last Update Date:2022-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXS2199208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery