Provider Demographics
NPI:1063771855
Name:SEWELL, ALLEN NEAL (SURGICAL ASSISTANT)
Entity type:Individual
Prefix:
First Name:ALLEN
Middle Name:NEAL
Last Name:SEWELL
Suffix:
Gender:M
Credentials:SURGICAL ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:256 SPRING MEADOW LN
Mailing Address - Street 2:
Mailing Address - City:SCHERTZ
Mailing Address - State:TX
Mailing Address - Zip Code:78154-3016
Mailing Address - Country:US
Mailing Address - Phone:210-279-9574
Mailing Address - Fax:
Practice Address - Street 1:256 SPRING MEADOW LANE
Practice Address - Street 2:
Practice Address - City:SCHERTZ
Practice Address - State:TX
Practice Address - Zip Code:78154
Practice Address - Country:US
Practice Address - Phone:210-279-9574
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-14
Last Update Date:2012-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant