MEDICARE: DUCK-GI M. SEO M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	F2359	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1043336274
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DUCK-GI M. SEO M.D.

Provider Business Mailing Address
First Line	:	10131 HAMMERLY BLVD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77080-5014
Country	:	US
Telephone Number	:	713-461-8022
Fax Number	:	713-461-8023

Provider Business Practice Location Address
First Line	:	10131 HAMMERLY BLVD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77080-5014
Country	:	US
Telephone Number	:	713-461-8022
Fax Number	:	713-461-8023

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/21/2007
Last Update Date	:	01/29/2019

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