Healthcare Provider Details

I. General information

NPI: 1568604262
Provider Name (Legal Business Name): GARETT JAMES SEEBA DMD, MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/27/2009
Last Update Date: 05/21/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

595 E MEDICAL CENTER BLVD
WEBSTER TX
77598-4326
US

IV. Provider business mailing address

595 E MEDICAL CENTER BLVD
WEBSTER TX
77598-4326
US

V. Phone/Fax

Practice location:
  • Phone: 281-461-1982
  • Fax: 281-461-0261
Mailing address:
  • Phone: 281-461-1982
  • Fax: 281-461-0261

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number28567
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code204E00000X
TaxonomyOral & Maxillofacial Surgery (D.M.D.)
License NumberQ3793
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: