Individual provider Active NPI

John Raymond Seals, MD

  • Neurology with Special Qualifications in Child Neurology Physician
  • San Antonio, TX
National Provider Identifier
1639171929
Registry record updated Oct 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology with Special Qualifications in Child Neurology PhysicianTaxonomy code 2084N0402X
License
D3395 Issued in TX
Practice address
4410 Medical Dr
Ste 400
San Antonio, TX 78229-3855
Phone
(210) 615-2255
Fax
(210) 615-8120
NPI assigned
Jun 1, 2005
Last updated
Oct 9, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology with Special Qualifications in Child Neurology Physician 2084N0402X D3395 TX Primary

Addresses

Primary practice location

4410 Medical Dr
Ste 400
San Antonio, TX 78229-3855

Mailing address

4410 Medical Dr
Ste 400
San Antonio, TX 78229-3855
Phone (210) 615-2255

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
I20100308000778 TX Practitioner - Neurology 2264577709 Practice locations: San Antonio, TX

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D3395TXMDNeurology with Special Qualifications in Child Neurology Physician

NPI Registry JSON

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

{
    "created_epoch": "1117584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191888000000",
    "number": "1639171929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4410 MEDICAL DR",
            "address_2": "STE 400",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293855",
            "telephone_number": "210-615-2255",
            "fax_number": "210-615-8120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4410 MEDICAL DR",
            "address_2": "STE 400",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293855",
            "telephone_number": "210-615-2255",
            "fax_number": "210-615-8120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEALS",
        "first_name": "JOHN",
        "middle_name": "RAYMOND",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-01",
        "last_updated": "2007-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "TX",
            "license": "D3395",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.