LAURENCE WEIDER MD PA
Radiology at Forest Ln, Dallas, TX

License number
Texas J4602
Category
Radiology
Type
Plastic and Reconstructive Surgery
Owner
Name: DR. LAURENCE AVRAM WEIDER M.D.
Title: PLASTIC SURGEON
Phone: (972) 566-8444
Address
Address
7777 Forest Ln SUITE B-145, Dallas, TX 75230
National Provider ID: 1669545331
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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LAURENCE A. WEIDER, M.D., PA

7777 Frst Ln STE B145, Dallas, TX 75230

Registration:
Feb 4, 2004
State ID:
0800300964
Business type:
Professional Association
President , Director , Member:
Laurence A. Weider (President , Director , Member)
Agent:
Jacob N. Pollack,8333 Douglas Ave STE 1200, Dallas, TX 75225 (Physical)
TIN:
32035651291

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