Provider Demographics
NPI:1639146160
Name:HIPP, SEAN JOSEPH (MD)
Entity Type:Individual
Prefix:DR
First Name:SEAN
Middle Name:JOSEPH
Last Name:HIPP
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3551 ROGER BROOKE DR
Mailing Address - Street 2:DEPT. OF PEDIATRICS
Mailing Address - City:FORT SAM HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:78234-4504
Mailing Address - Country:US
Mailing Address - Phone:210-916-7727
Mailing Address - Fax:916-916-9319
Practice Address - Street 1:3551 ROGER BROOKE DR
Practice Address - Street 2:DEPT. OF PEDIATRICS
Practice Address - City:FORT SAM HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:78234-4504
Practice Address - Country:US
Practice Address - Phone:210-916-7727
Practice Address - Fax:916-916-9319
Is Sole Proprietor?:No
Enumeration Date:2006-03-03
Last Update Date:2015-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD425029208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics