Provider Demographics
NPI:1235202169
Name:SEDLER, ROSS (MD)
Entity Type:Individual
Prefix:
First Name:ROSS
Middle Name:
Last Name:SEDLER
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 1:3601 21ST
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79410-1229
Mailing Address - Country:US
Mailing Address - Phone:806-797-2222
Mailing Address - Fax:806-792-7287
Practice Address - Street 1:3601 21ST
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79410-1229
Practice Address - Country:US
Practice Address - Phone:806-797-2222
Practice Address - Fax:806-792-7287
Is Sole Proprietor?:No
Enumeration Date:2006-11-16
Last Update Date:2008-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE7734207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8U7699OtherBCBS
TX8U7699OtherBCBS
B26310Medicare UPIN
TX8G2532Medicare PIN