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General NPI Number Information
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NPI Number | 1124344387
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Entity Type | Individual
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Provider Name | SEAN MICHAEL RODEN D.C., B.S., CCSP
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Gender | Male
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Dates
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Enumeration Date | 04/13/2010
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Last Update Date | 09/28/2018
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Provider Practice Location Address
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Address Line | 2750 INTERSTATE 10 E STE 200
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City | BEAUMONT
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State | TX
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Zip | 77703-4979
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Country | US
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Telephone | 409-242-6442
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Fax | 855-669-9969
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Provider Business Mailing Address
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Address Line | 4421 NOBLES AND GEHEB RD
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City | BEAUMONT
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State | TX
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Zip | 77713-3177
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Country | US
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Telephone | 281-608-5330
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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 | 11356
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License Number State | TX
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