Provider Demographics
NPI:1881796274
Name:SEYMOUR, STANLEY DEE (DC)
Entity type:Individual
Prefix:DR
First Name:STANLEY
Middle Name:DEE
Last Name:SEYMOUR
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2681 STATE HWY 361
Mailing Address - Street 2:
Mailing Address - City:INGLESIDE
Mailing Address - State:TX
Mailing Address - Zip Code:78362
Mailing Address - Country:US
Mailing Address - Phone:361-776-9355
Mailing Address - Fax:361-776-1985
Practice Address - Street 1:2681 STATE HWY 361
Practice Address - Street 2:
Practice Address - City:INGLESIDE
Practice Address - State:TX
Practice Address - Zip Code:78362
Practice Address - Country:US
Practice Address - Phone:361-776-9355
Practice Address - Fax:361-776-1985
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-05
Last Update Date:2013-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2822111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
T15845Medicare UPIN
TX609827Medicare ID - Type Unspecified