Individual
JEREMY S SEBASTIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3816 S 1ST ST, AUSTIN, TX 78704-7048
(512) 443-1311
(512) 406-6266
Mailing address
PO BOX 26726, AUSTIN, TX 78755-0726
(512) 407-8686
(512) 406-6216
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
M8983
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
199215801
—
TX
05
—
199215803
—
TX
05
—
199215804
—
TX
05
—
199215805
—
TX
01
—
8BL260
BCBS
TX
Enumeration date
03/05/2008
Last updated
08/25/2014
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