Provider Demographics
NPI:1558868760
Name:HUNT, SEAN TIMATHIE (DO)
Entity Type:Individual
Prefix:
First Name:SEAN
Middle Name:TIMATHIE
Last Name:HUNT
Suffix:
Gender:M
Credentials:DO
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 271600
Mailing Address - Street 2:
Mailing Address - City:FLOWER MOUND
Mailing Address - State:TX
Mailing Address - Zip Code:75027-1600
Mailing Address - Country:US
Mailing Address - Phone:972-544-6600
Mailing Address - Fax:972-544-6604
Practice Address - Street 1:1023 LIPSCOMB ST STE 200
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76104-3102
Practice Address - Country:US
Practice Address - Phone:972-544-6600
Practice Address - Fax:972-544-6604
Is Sole Proprietor?:No
Enumeration Date:2018-04-13
Last Update Date:2023-02-23
Deactivation Date:2021-08-08
Deactivation Code:
Reactivation Date:2021-08-25
Provider Licenses
StateLicense IDTaxonomies
390200000X
TXT2633207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program