Healthcare Provider Details

I. General information

NPI: 1841873890
Provider Name (Legal Business Name): SEAN M LIVINGSTON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/28/2021
Last Update Date: 09/11/2024
Certification Date: 09/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7900 FM 1826 STE 202
AUSTIN TX
78737-1412
US

IV. Provider business mailing address

6034 W COURTYARD DR STE 110
AUSTIN TX
78730-5064
US

V. Phone/Fax

Practice location:
  • Phone: 512-288-9669
  • Fax: 512-498-0321
Mailing address:
  • Phone: 512-838-3828
  • Fax: 254-306-4676

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberV0027
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: