Provider Demographics
NPI:1679386601
Name:WEIKERT, COLBY BLAIN
Entity type:Individual
Prefix:
First Name:COLBY
Middle Name:BLAIN
Last Name:WEIKERT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24120 OSCAR RD
Mailing Address - Street 2:
Mailing Address - City:SPICEWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:78669-2622
Mailing Address - Country:US
Mailing Address - Phone:208-971-4383
Mailing Address - Fax:
Practice Address - Street 1:150 BRAND STE 700
Practice Address - Street 2:
Practice Address - City:MURPHY
Practice Address - State:TX
Practice Address - Zip Code:75094-3734
Practice Address - Country:US
Practice Address - Phone:469-445-2445
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-31
Last Update Date:2025-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical