Provider Demographics
NPI:1922400787
Name:DALY, SEAN T (L S A)
Entity Type:Individual
Prefix:
First Name:SEAN
Middle Name:T
Last Name:DALY
Suffix:
Gender:M
Credentials:L S A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7000 SW 9TH AVE
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79106-1709
Mailing Address - Country:US
Mailing Address - Phone:806-350-3500
Mailing Address - Fax:806-359-3094
Practice Address - Street 1:7000 SW 9TH AVE
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79106-1709
Practice Address - Country:US
Practice Address - Phone:806-350-3500
Practice Address - Fax:806-359-3094
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-23
Last Update Date:2014-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXSA00035246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant