Provider Demographics
NPI:1720041056
Name:SEYMOUR, GREGORY T (MD)
Entity Type:Individual
Prefix:
First Name:GREGORY
Middle Name:T
Last Name:SEYMOUR
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 1:22710 PROFESSIONAL DRIVE
Mailing Address - Street 2:
Mailing Address - City:KINGWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77339-6009
Mailing Address - Country:US
Mailing Address - Phone:281-312-8560
Mailing Address - Fax:281-312-8561
Practice Address - Street 1:22710 PROFESSIONAL DR
Practice Address - Street 2:
Practice Address - City:KINGWOOD
Practice Address - State:TX
Practice Address - Zip Code:77339-6008
Practice Address - Country:US
Practice Address - Phone:281-298-8444
Practice Address - Fax:281-298-7720
Is Sole Proprietor?:No
Enumeration Date:2006-04-08
Last Update Date:2016-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK9663207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX147289602Medicaid
TX8A0729Medicare ID - Type Unspecified
TXP00074657Medicare PIN
H50615Medicare UPIN