Provider Demographics
NPI:1295098168
Name:ARREDONDO, SEAN DANIEL (MD)
Entity type:Individual
Prefix:DR
First Name:SEAN
Middle Name:DANIEL
Last Name:ARREDONDO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3015 CHENEVERT ST UNIT 6
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77004-3045
Mailing Address - Country:US
Mailing Address - Phone:210-365-2325
Mailing Address - Fax:
Practice Address - Street 1:2460 N IH 35 E STE 215
Practice Address - Street 2:
Practice Address - City:WAXAHACHIE
Practice Address - State:TX
Practice Address - Zip Code:75165
Practice Address - Country:US
Practice Address - Phone:469-800-9830
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-16
Last Update Date:2018-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP10046912390200000X
MO2012021967390200000X
TXR7650208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program