MEDICARE: SEAN WEED

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225200000X	Physical Therapy Assistant

General Provider Information

NPI Number	:	1609589365
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SEAN WEED

Provider Business Mailing Address
First Line	:	1029 SEMINOLE TRL
Second Line	:
City	:	CARROLLTON
State	:	TX
Zip	:	75007-6200
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1029 SEMINOLE TRL
Second Line	:
City	:	CARROLLTON
State	:	TX
Zip	:	75007-6200
Country	:	US
Telephone Number	:	972-366-4837
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/27/2022
Last Update Date	:	12/27/2022

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Directions to “ SEAN WEED ” Practice Location

Language	Start Address	Practice Location

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