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General NPI Number Information
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NPI Number | 1083080790
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Entity Type | Individual
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Provider Name | BENJAMIN SANFORD SHEEHAN D.C.
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Gender | Male
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Dates
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Enumeration Date | 08/17/2015
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Last Update Date | 08/17/2015
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Provider Practice Location Address
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Address Line | 3027 MARINA BAY DR SUITE 203
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City | LEAGUE CITY
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State | TX
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Zip | 77573-2729
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Country | US
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Telephone | 409-599-9697
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Fax |
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Provider Business Mailing Address
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Address Line | 12020 10TH ST
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City | SANTA FE
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State | TX
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Zip | 77510-8623
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Country | US
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Telephone | 409-599-9697
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 12977
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License Number State | TX
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