Provider Demographics
| NPI: | 1770902892 |
|---|---|
| Name: | SEAWORTH, HEMA N (MD) |
| Entity type: | Individual |
| Prefix: | |
| First Name: | HEMA |
| Middle Name: | N |
| Last Name: | SEAWORTH |
| Suffix: | |
| Gender: | F |
| Credentials: | MD |
| Other - Prefix: | |
| Other - First Name: | HEMA |
| Other - Middle Name: | L |
| Other - Last Name: | NAVANEETHAN |
| Other - Suffix: | |
| Other - Last Name Type: | Former Name |
| Other - Credentials: | |
| Mailing Address - Street 1: | 4502 MEDICAL DR |
| Mailing Address - Street 2: | |
| Mailing Address - City: | SAN ANTONIO |
| Mailing Address - State: | TX |
| Mailing Address - Zip Code: | 78229-4402 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 210-358-4000 |
| Mailing Address - Fax: | |
| Practice Address - Street 1: | 4502 MEDICAL DR |
| Practice Address - Street 2: | |
| Practice Address - City: | SAN ANTONIO |
| Practice Address - State: | TX |
| Practice Address - Zip Code: | 78229-4402 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 210-358-4000 |
| Practice Address - Fax: | |
| Is Sole Proprietor?: | No |
| Enumeration Date: | 2014-04-16 |
| Last Update Date: | 2024-10-29 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Licenses
| State | License ID | Taxonomies |
|---|---|---|
| NE | 30764 | 208000000X |
| MO | 2014019463 | 208000000X |
| TX | S9943 | 2080H0002X, 208000000X |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization |
|---|---|---|---|---|
| Yes | 2080H0002X | Allopathic & Osteopathic Physicians | Pediatrics | Hospice and Palliative Medicine |
| No | 208000000X | Allopathic & Osteopathic Physicians | Pediatrics |
Provider Identifiers
| State | Identifier ID | ID Type | Issuer |
|---|---|---|---|
| TX | 422124403 | Medicaid | |
| TX | 422124404 | Other | CSHCN |