Provider Demographics
NPI:1558357707
Name:HAYES, SEAN M (PT CSCS)
Entity Type:Individual
Prefix:
First Name:SEAN
Middle Name:M
Last Name:HAYES
Suffix:
Gender:M
Credentials:PT CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20403 UNIVERSITY BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-4977
Mailing Address - Country:US
Mailing Address - Phone:281-325-0188
Mailing Address - Fax:281-325-0189
Practice Address - Street 1:20403 UNIVERSITY BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-4976
Practice Address - Country:US
Practice Address - Phone:281-325-0188
Practice Address - Fax:281-325-0189
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1138931208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8E0330Medicare ID - Type Unspecified