| Amanda Elizabeth Weaver, MD | |
| 
					2237 S Jackson St, San Angelo, TX 76904-5131  | |
| (325) 747-1511 | |
| Not Available | 
| Full Name | Amanda Elizabeth Weaver | 
|---|---|
| Gender | Female | 
| Speciality | Family Medicine - Sports Medicine | 
| Location | 2237 S Jackson St, San Angelo, Texas | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1295350999 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 207Q00000X | Family Medicine | T6074 (Texas) | Secondary | 
| 207QS0010X | Family Medicine - Sports Medicine | T6074 (Texas) | Primary | 
| Entity Name | Shannon Clinic | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1770587149 PECOS PAC ID: 0840103727 Enrollment ID: O20031222000702  | 
| Mailing Address | Practice Location Address | 
|---|---|
| Amanda Elizabeth Weaver, MD 2237 S Jackson St, San Angelo, TX 76904-5131 Ph: (325) 747-1511  | Amanda Elizabeth Weaver, MD 2237 S Jackson St, San Angelo, TX 76904-5131 Ph: (325) 747-1511  | 
Irvin E. Zeitler Jr., DO Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 120 E Beauregard Ave, San Angelo, TX 76903 Phone: 325-658-1511  | |
Gary P Phillips, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 2626 N Bryant Blvd, San Angelo, TX 76903 Phone: 325-658-1511  | |
Dr. Jack P Campbell, M.D. Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 2626 N Bryant Blvd, San Angelo, TX 76903 Phone: 325-658-1511 Fax: 325-481-2166  | |
Seth Sturdivant, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 120 E Harris Ave, San Angelo, TX 76903 Phone: 325-481-6410  | |
Brett Jason Nile, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 2142 Sunset Dr, San Angelo, TX 76904 Phone: 325-747-2635 Fax: 325-747-2798  | |
Darrell T Herrington, DO Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 3605 Executive Dr, San Angelo, TX 76904 Phone: 325-949-9555  | |
Christopher C Peterson, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 2142 Sunset Dr, San Angelo, TX 76904 Phone: 325-245-4059 Fax: 325-245-4059  |