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NPI Code Detail

MEDICARE: DR. SEAN D DELUE M.D.

MEDICARE: DR. SEAN D DELUE 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
1207Q00000XFamily Medicine PhysicianL7709TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1N0131532OTHERTXDPS
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1477525004
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SEAN D DELUE M.D.
Provider Business Mailing Address
First Line : PO BOX 844658
Second Line :
City : DALLAS
State : TX
Zip : 75284-4658
Country : US
Telephone Number : 800-944-0371
Fax Number : 254-215-9722
Provider Business Practice Location Address
First Line : 7700 FISH POND RD
Second Line :
City : WACO
State : TX
Zip : 76710-1031
Country : US
Telephone Number : 254-761-4444
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/07/2006
Last Update Date : 09/12/2023

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Directions to “ DR. SEAN D DELUE M.D.” Practice Location

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