Provider Demographics
NPI:1346880762
Name:SEASTRUNK, CREON TALEMEDIUS JR (DC)
Entity Type:Individual
Prefix:DR
First Name:CREON
Middle Name:TALEMEDIUS
Last Name:SEASTRUNK
Suffix:JR
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:503 W EULESS BLVD
Mailing Address - Street 2:
Mailing Address - City:EULESS
Mailing Address - State:TX
Mailing Address - Zip Code:76040-4426
Mailing Address - Country:US
Mailing Address - Phone:817-267-8850
Mailing Address - Fax:
Practice Address - Street 1:503 W EULESS BLVD
Practice Address - Street 2:
Practice Address - City:EULESS
Practice Address - State:TX
Practice Address - Zip Code:76040-4426
Practice Address - Country:US
Practice Address - Phone:817-267-8850
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-14
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14311111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor