Provider Demographics
NPI:1639949027
Name:COMBS, SETH DEAN I
Entity Type:Individual
Prefix:
First Name:SETH
Middle Name:DEAN
Last Name:COMBS
Suffix:I
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:311 E STAN SCHLUETER LOOP STE 208
Mailing Address - Street 2:
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76542-6641
Mailing Address - Country:US
Mailing Address - Phone:254-768-2112
Mailing Address - Fax:
Practice Address - Street 1:311 E STAN SCHLUETER LOOP STE 208
Practice Address - Street 2:
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76542-6641
Practice Address - Country:US
Practice Address - Phone:254-768-2112
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-05
Last Update Date:2024-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician