Provider Demographics
NPI:1225425580
Name:MCLEOD, SEAN
Entity Type:Individual
Prefix:
First Name:SEAN
Middle Name:
Last Name:MCLEOD
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 1:405 STATE HIGHWAY 121 BYP STE A250
Mailing Address - Street 2:
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75067-4183
Mailing Address - Country:US
Mailing Address - Phone:469-906-2399
Mailing Address - Fax:469-906-2367
Practice Address - Street 1:405 STATE HIGHWAY 121 BYP STE A250
Practice Address - Street 2:
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75067-4183
Practice Address - Country:US
Practice Address - Phone:469-906-2399
Practice Address - Fax:469-906-2367
Is Sole Proprietor?:No
Enumeration Date:2015-04-23
Last Update Date:2023-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX016919372600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion