MEDICARE: ANDREW MORRIS SEBBY DO, MPH

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	2083P0500X	Preventive Medicine/Occupational Environmental Medicine Physician	M2796	TX
2	2083P0901X	Public Health & General Preventive Medicine Physician	M2796	TX
3	2083X0100X	Occupational Medicine Physician	M2796	TX

General Provider Information

NPI Number	:	1578558136
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREW MORRIS SEBBY DO, MPH

Provider Business Mailing Address
First Line	:	2305 ELLINGHAM
Second Line	:
City	:	WICHITA FALLS
State	:	TX
Zip	:	76308-2042
Country	:	US
Telephone Number	:	940-761-5330
Fax Number	:

Provider Business Practice Location Address
First Line	:	2305 ELLINGHAM
Second Line	:
City	:	WICHITA FALLS
State	:	TX
Zip	:	76308-2042
Country	:	US
Telephone Number	:	940-761-5330
Fax Number	:

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

Provider Enumeration Date	:	09/20/2005
Last Update Date	:	07/11/2007

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