Individual
JACK L. SEAQUIST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
D9654
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
094771502
—
TX
05
—
117193604
—
TX
01
—
4048662
AETNA TRS
TX
01
—
817420
SCOTT & WHITE
TX
Enumeration date
07/03/2006
Last updated
10/13/2010
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