Provider Demographics
NPI:1144591082
Name:TOWNSEND, SEAN S (PA)
Entity Type:Individual
Prefix:
First Name:SEAN
Middle Name:S
Last Name:TOWNSEND
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13802 CENTERFIELD RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77070-6044
Mailing Address - Country:US
Mailing Address - Phone:281-737-0999
Mailing Address - Fax:
Practice Address - Street 1:13802 CENTERFIELD RD
Practice Address - Street 2:SUITE 300
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77070-6044
Practice Address - Country:US
Practice Address - Phone:281-737-0999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-24
Last Update Date:2014-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1102776363A00000X
TXPA07658363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX305773901Medicaid
616771105OtherUS DEPT OF LABOR
601771109OtherUS DEPT OF LABOR
616771101OtherUS DEPT OF LABOR
TX1144591082OtherBLUE CROSS BLUE SHIELD
616771110OtherUS DEPT OF LABOR
TX305773902Medicaid
616771110OtherUS DEPT OF LABOR
616771101OtherUS DEPT OF LABOR
TXTXB151440Medicare PIN