Provider Demographics
NPI:1477651982
Name:EMMETT, DANIEL SETH (MD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:SETH
Last Name:EMMETT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 10597
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78766-1597
Mailing Address - Country:US
Mailing Address - Phone:512-485-5878
Mailing Address - Fax:512-420-0397
Practice Address - Street 1:4310 JAMES CASEY ST
Practice Address - Street 2:STE 4A
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78745-1251
Practice Address - Country:US
Practice Address - Phone:512-448-4588
Practice Address - Fax:512-445-4511
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2009-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL7370207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX203081901Medicaid
TX8BW384OtherBCBSTX INDIVIDUAL NUMBER
TX203081901Medicaid