Provider Demographics
NPI:1326360751
Name:SEO, EUNAE RITA (PA-C)
Entity Type:Individual
Prefix:
First Name:EUNAE
Middle Name:RITA
Last Name:SEO
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3060 COMMUNICATIONS PKWY STE 100
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-8450
Mailing Address - Country:US
Mailing Address - Phone:972-312-0607
Mailing Address - Fax:972-312-0805
Practice Address - Street 1:3060 COMMUNICATIONS PKWY STE 100
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-8450
Practice Address - Country:US
Practice Address - Phone:972-312-0607
Practice Address - Fax:972-312-0805
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-26
Last Update Date:2010-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA06654363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant