Provider Demographics
NPI:1396386348
Name:SEAMON, MICHAEL (APRN)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:
Last Name:SEAMON
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 W 38TH ST STE 200
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78731-6405
Mailing Address - Country:US
Mailing Address - Phone:512-324-3540
Mailing Address - Fax:512-324-3512
Practice Address - Street 1:1600 W 38TH ST STE 200
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78731-6405
Practice Address - Country:US
Practice Address - Phone:512-324-3540
Practice Address - Fax:512-324-3512
Is Sole Proprietor?:No
Enumeration Date:2019-10-01
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV825950363LA2100X, 363LA2200X
TX1071126363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1071126OtherTX APRN LICENSE
14555168OtherCAQH #
NV825950OtherNV APRN LICENSE