Healthcare Provider Details
I. General information
NPI: 1295098168
Provider Name (Legal Business Name): SEAN DANIEL ARREDONDO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/16/2012
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
10622 BURNET RD STE 100
AUSTIN TX
78758-4482
US
IV. Provider business mailing address
12411 LONE MOUNTAIN PASS
LEANDER TX
78641-3826
US
V. Phone/Fax
- Phone: 512-334-9917
- Fax: 512-294-4891
- Phone: 210-365-2325
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208200000X |
| Taxonomy | Plastic Surgery Physician |
| License Number | MD230996 |
| License Number State | OR |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208200000X |
| Taxonomy | Plastic Surgery Physician |
| License Number | R7650 |
| License Number State | TX |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: