Doctor Name: | MR. SEAN JAMES MCDOUGALL |
NPI Number: | 1639525330 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | AP130202 |
Business Practice Address: | 1036 N Circle Dr Sealy, TX - 774743336 |
Business Phone Number: | 9798770022 |
Business Fax Number: | 9798853810 |
Mailing Address: | 1036 N Circle Dr, SEALY |
State: | TX |
Postal Code: | 774743336 |
Phone Number: | 9798770022 |
Fax Number: | 9798853810 |
NPI Enumeration Date: | 05/11/2016 |
NPI Last Update Date: | 05/11/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | AP130202 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |