Provider Demographics
NPI:1295150951
Name:DRIGGERS, SEAN (PA-C)
Entity type:Individual
Prefix:
First Name:SEAN
Middle Name:
Last Name:DRIGGERS
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1305 W JEFFERSON ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:WAXAHACHIE
Mailing Address - State:TX
Mailing Address - Zip Code:75165-2269
Mailing Address - Country:US
Mailing Address - Phone:469-800-9400
Mailing Address - Fax:469-800-9410
Practice Address - Street 1:1305 W JEFFERSON ST
Practice Address - Street 2:SUITE 100
Practice Address - City:WAXAHACHIE
Practice Address - State:TX
Practice Address - Zip Code:75165-2269
Practice Address - Country:US
Practice Address - Phone:469-800-9400
Practice Address - Fax:469-800-9410
Is Sole Proprietor?:No
Enumeration Date:2014-03-04
Last Update Date:2022-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA09036363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX3376360-01Medicaid
TX3376360-01Medicaid