SHELLEY ETHAN WEISS (NPI# 1699793760) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699793760 |
| Entity Type | Individual |
| Full Name | SHELLEY ETHAN WEISS |
| Credential | M.D. |
| Practice Address |
7777 Forest Ln Ste C550 Dallas TX 75230-7518 |
| Mailing Address |
P.o. Box 961205 Fort Worth TX 76161-1205 |
| Practice Telephone | 9725664286 |
| Practice Fax Number | 9725668634 |
| Mailing Telephone | 8177408450 |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2019-09-20 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | L0958 | TX | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 168133001 | 05 | |
| TX | 168133002 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588718548 | Shelley Jan Weiss | Speech-Language Pathologist | 815 Centre St, #5, Jamaica Plain, MA 02130-2735 | 2007-01-23 |
| 1053875500 | Shelley Weiss | Counselor | 770 Woodlane Rd, Westampton, NJ 08060-3804 | 2019-01-29 |
| Street Address |
7777 FOREST LN STE C550 |
| City | DALLAS |
| State | TX |
| Zip Code | 75230-7518 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912552415 | Kyoto Medical Services, Pllc | Orthopaedic Surgery | 12890 Hillcrest Plaza Drive, Suite K111, Dallas, TX 75230 | 2019-08-02 |
| 1528538170 | Angel Laamber Adams | Nurse Practitioner | 7777 Forest Lane Suite C 833, Dallas, TX 75230 | 2018-11-27 |
| 1538634399 | Tochukwu Chioma Uche-ukah | Nurse Practitioner | Dr Katari, Encompass Health Rehabilitations, 7930 Northaven Rd, Dallas, TX 75230 | 2018-10-09 |
| 1790260958 | Ability Aba, Pllc | Behavioral Analyst | 5930 Royal Lane Ste E, #301, Dallas, TX 75230 | 2018-10-03 |
| 1750887956 | Brandi Nicole Freeman | Behavioral Analyst | 5639 Mcshann Rd, Dallas, TX 75230 | 2018-04-05 |
| 1326547720 | Whitney A Stewart | Psychologist | 5924 Royal Lane, Ste 258, Preston Hollow Health & Wellness, Dallas, TX 75230 | 2018-02-12 |
| 1407384373 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 7859 Walnut Hill Ln Ste 110, Dallas, TX 75230 | 2017-05-23 |
| 1215488648 | The Walker Wellness Clinic | Community/Behavioral Health | 12200 Preston Rd., Dallas, TX 75230 | 2016-10-20 |
| 1578912325 | Renat Kudyakov | Nurse Practitioner | 7777 Forest Ln Ste B-446, Dallas, TX 75230 | 2016-06-11 |
| 1407210982 | Rohan Venugopal Menon | Pediatrics | 7777 Forest Lane, Bldg B 300, Dallas, TX 75230 | 2016-04-11 |
| Find all providers in zip 75230 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982131363 | Julia C Durante | Pediatrics | 2350 N Stemmons Fwy Ste F5200, Dallas, TX 75207-2700 | 2017-05-17 |
| 1891235206 | Jill Whitehurst | Pediatrics | 6436 Glendora Ave, Dallas, TX 75230-5125 | 2017-03-03 |
| 1407210982 | Rohan Venugopal Menon | Pediatrics | 7777 Forest Lane, Bldg B 300, Dallas, TX 75230 | 2016-04-11 |
| 1144686601 | Souren Chakmakjian | Pediatrics | 3855 Branchfield Dr, Dallas, TX 75214-2949 | 2016-01-13 |
| 1851756977 | Aaron L. Kreisler, M.d. P.a. | Pediatrics | 1151 N Buckner Blvd # Pb1, Suite 203, Dallas, TX 75218-3426 | 2015-12-16 |
| 1679982540 | Mevelline Lim | Pediatrics | 2350 N Stemmons Fwy Ste 2400, Dallas, TX 75207-2700 | 2014-08-05 |
| 1134549983 | Diana Liz Arriola | Pediatrics | 3434 W Illinois Ave Ste 306-3, Dallas, TX 75211-8709 | 2014-04-20 |
| 1386064269 | Jennifer Nguyen Chew | Pediatrics | 6300 Harry Hines Blvd Ste 101, Dallas, TX 75235-5259 | 2014-04-18 |
| 1215379987 | Colleen D Edge | Pediatrics | 8355 Walnut Hill Ln Ste 105, Dallas, TX 75231-4242 | 2013-07-23 |
| 1083055214 | Richard William Markus | Pediatrics | 7777 Forest Ln Ste B320, Dallas, TX 75230-6820 | 2013-07-16 |
| Find all providers in DALLAS | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.