MEDICARE: SOMMAI SEHAPAYAK MD

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	208C00000X	Colon & Rectal Surgery Physician	E1124	TX

General Provider Information

NPI Number	:	1275544330
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SOMMAI SEHAPAYAK MD

Provider Business Mailing Address
First Line	:	1050 W ROSEDALE ST
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76104-4422
Country	:	US
Telephone Number	:	817-338-4501
Fax Number	:	817-338-4503

Provider Business Practice Location Address
First Line	:	1050 W ROSEDALE ST
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76104-4422
Country	:	US
Telephone Number	:	817-338-4501
Fax Number	:	817-338-4503

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

Provider Enumeration Date	:	08/11/2006
Last Update Date	:	08/25/2008

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