Individual
JEAN L SEIGNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.-C
Contact information
Practice address
4701 BOAT CLUB RD., SUITE 200, FORT WORTH, TX 76135-5285
(817) 237-0515
Mailing address
4701 BOAT CLUB RD., SUITE 200, FORT WORTH, TX 76135-5285
(817) 237-0515
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA05229
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
325723001
—
TX
01
—
PA05229
STATE LICENSE
TX
Enumeration date
06/14/2007
Last updated
02/23/2022
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