Provider Demographics
NPI:1790077865
Name:SEELY, RON (ATP, CRTS)
Entity Type:Individual
Prefix:
First Name:RON
Middle Name:
Last Name:SEELY
Suffix:
Gender:M
Credentials:ATP, CRTS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1517 W NORTH CARRIER PKWY
Mailing Address - Street 2:#110
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75050-1288
Mailing Address - Country:US
Mailing Address - Phone:972-206-7345
Mailing Address - Fax:972-522-0103
Practice Address - Street 1:1517 W NORTH CARRIER PKWY
Practice Address - Street 2:#110
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75050-1288
Practice Address - Country:US
Practice Address - Phone:972-206-7345
Practice Address - Fax:972-522-0103
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-09
Last Update Date:2011-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other