Provider Demographics
NPI:1558461798
Name:SEELBACK, CASI QUINN (PT)
Entity Type:Individual
Prefix:
First Name:CASI
Middle Name:QUINN
Last Name:SEELBACK
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 41027
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77241-1027
Mailing Address - Country:US
Mailing Address - Phone:281-482-7380
Mailing Address - Fax:281-482-0781
Practice Address - Street 1:133 W PARKWOOD AVE
Practice Address - Street 2:
Practice Address - City:FRIENDSWOOD
Practice Address - State:TX
Practice Address - Zip Code:77546-5420
Practice Address - Country:US
Practice Address - Phone:281-482-7380
Practice Address - Fax:281-482-0781
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1167140225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist