Provider Demographics
NPI:1669851903
Name:MCCOY, SEAN K (DO)
Entity Type:Individual
Prefix:
First Name:SEAN
Middle Name:K
Last Name:MCCOY
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 1:5106 ALLEGANY DR
Mailing Address - Street 2:
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76549-5713
Mailing Address - Country:US
Mailing Address - Phone:330-310-1831
Mailing Address - Fax:
Practice Address - Street 1:36000 DARNALL LOOP
Practice Address - Street 2:ATTN: MCXI-DEM
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76544-5095
Practice Address - Country:US
Practice Address - Phone:254-288-8303
Practice Address - Fax:254-288-8336
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-19
Last Update Date:2019-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX390200000X286500000X
NC2018-02287207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No286500000XHospitalsMilitary Hospital