Provider Demographics
NPI:1639525330
Name:MCDOUGALL, SEAN JAMES
Entity Type:Individual
Prefix:MR
First Name:SEAN
Middle Name:JAMES
Last Name:MCDOUGALL
Suffix:
Gender:M
Credentials:
Other - Prefix:MR
Other - First Name:SEAN
Other - Middle Name:JAMES
Other - Last Name:MCDOUGALL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:FNP
Mailing Address - Street 1:15035 SOUTHWEST FWY
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-5018
Mailing Address - Country:US
Mailing Address - Phone:281-344-1715
Mailing Address - Fax:713-452-4135
Practice Address - Street 1:15035 SOUTHWEST FWY
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-5018
Practice Address - Country:US
Practice Address - Phone:281-344-1715
Practice Address - Fax:713-452-4135
Is Sole Proprietor?:No
Enumeration Date:2016-05-11
Last Update Date:2017-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP130202363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily