Healthcare Provider Details

I. General information

NPI: 1720041056
Provider Name (Legal Business Name): GREGORY T SEYMOUR MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/08/2006
Last Update Date: 06/06/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22710 PROFESSIONAL DR
KINGWOOD TX
77339-6008
US

IV. Provider business mailing address

22710 PROFESSIONAL DRIVE
KINGWOOD TX
77339-6009
US

V. Phone/Fax

Practice location:
  • Phone: 281-298-8444
  • Fax: 281-298-7720
Mailing address:
  • Phone: 281-312-8560
  • Fax: 281-312-8561

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License NumberK9663
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: