Individual provider Active NPI

Tiffani Michelle Sealock, M.D.

  • Family Medicine Physician
  • Houston, TX
National Provider Identifier
1326208257
Registry record updated Mar 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
M9641 Issued in TX
Practice address
424 Hahlo St
Houston, TX 77020-3022
Phone
(713) 674-3326
NPI assigned
Jun 13, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X M9641 TX Primary

Addresses

Primary practice location

424 Hahlo St
Houston, TX 77020-3022

Mailing address

424 Hahlo St
Houston, TX 77020-3022
Phone (713) 674-3326

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171101002016 TX Order and Referring Only - Family PracticePractitioner - Family Practice 0648317099

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
M9641TXMDFamily Medicine Physician

Interoperability endpoints

  • Direct secure messaging: tiffani.sealock.1@17081.direct.athenahealth.com

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1213315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331510400000",
    "number": "1326208257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "424 HAHLO ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770203022",
            "telephone_number": "713-674-3326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "424 HAHLO ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770203022",
            "telephone_number": "713-674-3326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEALOCK",
        "first_name": "TIFFANI",
        "middle_name": "MICHELLE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-13",
        "last_updated": "2012-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "M9641",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.