Individual provider Active NPI

Bobby Ray Seago

  • Athletic Trainer
  • Midlothian, TX
National Provider Identifier
1487861969
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
AT1703 Issued in TX
Practice address
100 Walter Stephenson Rd
Midlothian, TX 76065-3418
Phone
(972) 775-8174
Fax
(972) 775-5139
NPI assigned
May 16, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X AT1703 TX Primary

Addresses

Primary practice location

100 Walter Stephenson Rd
Midlothian, TX 76065-3418

Mailing address

1013 Lake Grove Loop
Midlothian, TX 76065-5643
Phone (972) 775-4674

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
AT1703TXMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1179273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1487861969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1013 LAKE GROVE LOOP",
            "city": "MIDLOTHIAN",
            "state": "TX",
            "postal_code": "760655643",
            "telephone_number": "972-775-4674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 WALTER STEPHENSON RD",
            "city": "MIDLOTHIAN",
            "state": "TX",
            "postal_code": "760653418",
            "telephone_number": "972-775-8174",
            "fax_number": "972-775-5139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEAGO",
        "first_name": "BOBBY",
        "middle_name": "RAY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "TX",
            "license": "AT1703",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Midlothian, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.