Provider Demographics
NPI:1649211871
Name:SEIVERT, SEAN PATRICK (DC)
Entity Type:Individual
Prefix:DR
First Name:SEAN
Middle Name:PATRICK
Last Name:SEIVERT
Suffix:
Gender:M
Credentials:DC
Other - Prefix:DR
Other - First Name:SEAN
Other - Middle Name:PATRICK
Other - Last Name:SEIVERT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DC
Mailing Address - Street 1:PO BOX 408
Mailing Address - Street 2:
Mailing Address - City:TAYLOR
Mailing Address - State:TX
Mailing Address - Zip Code:76574-0408
Mailing Address - Country:US
Mailing Address - Phone:512-352-1300
Mailing Address - Fax:512-352-1301
Practice Address - Street 1:1426 N MAIN ST STE 106
Practice Address - Street 2:
Practice Address - City:TAYLOR
Practice Address - State:TX
Practice Address - Zip Code:76574-3031
Practice Address - Country:US
Practice Address - Phone:512-352-1300
Practice Address - Fax:512-352-1301
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-09
Last Update Date:2020-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3359111N00000X
TX10890111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor