Individual
MR. FRED GREGORY SEBASTIAN IV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
3506 21ST ST, SUITE 507, LUBBOCK, TX 79410-1212
(806) 725-4805
Mailing address
3506 21ST ST, SUITE 507, LUBBOCK, TX 79410-1212
(806) 725-4805
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA10903
TX
Other
Enumeration date
11/07/2016
Last updated
11/07/2016
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