DR. JACKIE LYNN WEAVER DC PHARM D NPI 1720072523

NPI Information

  • NPI: 1720072523
  • Provider Name: DR. JACKIE LYNN WEAVER, DC, PHARM D
  • Classification: Chiropractor - 111N00000X
  • Entity Type: Individual
  • Address: 2726 W GENTRY PKWY
    TYLER, TX
    ZIP 75702
  • Phone: (903) 593-2533

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NPI Details

DR. Jackie Lynn Weaver, DC, PHARM D is a chiropractor in Tyler, TX. The provider is a provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. DR. Jackie Lynn Weaver, DC, PHARM D NPI is 1720072523. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

2726 W GENTRY PKWY
TYLER, TX
ZIP 75702-635
Phone: (903) 593-2533
Fax: (903) 593-2555

The enumeration date for this NPI number is 9/7/2005 and was last updated on 1/19/2017.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1111N00000XChiropractor6129 DCTEXASYes
2183500000XPharmacist48560TEXASNo

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1U638368MEDICARE UPIN
28K1680OTHERBLUE CROSS
3C06037715MEDICARE ID-TYPE UNSPECIFIEDTEXAS
4001665101MEDICAIDTEXAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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