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General NPI Number Information
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NPI Number | 1134693781
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Entity Type | Individual
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Provider Name | RUSSELL SEAY FNP-C
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Gender | Male
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Dates
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Enumeration Date | 01/16/2019
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Last Update Date | 12/13/2024
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Provider Practice Location Address
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Address Line | 10868 KUYKENDAHL RD STE E
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City | THE WOODLANDS
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State | TX
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Zip | 77381-2873
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Country | US
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Telephone | 346-478-0831
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Fax | 346-478-0833
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Provider Business Mailing Address
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Address Line | 321 W SAN AUGUSTINE ST
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City | DEER PARK
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State | TX
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Zip | 77536-4027
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Country | US
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Telephone | 713-802-0801
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Fax | 713-802-0105
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP139084
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License Number State | TX
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