Provider Demographics
NPI:1154319598
Name:BOUTROS, SEAN (MD)
Entity Type:Individual
Prefix:DR
First Name:SEAN
Middle Name:
Last Name:BOUTROS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9230 KATY FWY
Mailing Address - Street 2:STE 600
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77055-7468
Mailing Address - Country:US
Mailing Address - Phone:713-791-0700
Mailing Address - Fax:713-791-0703
Practice Address - Street 1:9230 KATY FWY STE 600
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77055-7468
Practice Address - Country:US
Practice Address - Phone:713-791-0700
Practice Address - Fax:713-791-0703
Is Sole Proprietor?:No
Enumeration Date:2005-10-10
Last Update Date:2020-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM06712082S0099X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2082S0099XAllopathic & Osteopathic PhysiciansPlastic SurgeryPlastic Surgery Within the Head and Neck