Provider Demographics
NPI:1124112743
Name:SEWARD, JEFFREY STEPHEN (MD)
Entity type:Individual
Prefix:
First Name:JEFFREY
Middle Name:STEPHEN
Last Name:SEWARD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:JEFFREY
Other - Middle Name:STEPHEN
Other - Last Name:SEWARD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:348 HUMMINGBIRD DR
Mailing Address - Street 2:
Mailing Address - City:NEW BRAUNFELS
Mailing Address - State:TX
Mailing Address - Zip Code:78130-9619
Mailing Address - Country:US
Mailing Address - Phone:903-701-0007
Mailing Address - Fax:
Practice Address - Street 1:348 HUMMINGBIRD DR
Practice Address - Street 2:
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78130-9619
Practice Address - Country:US
Practice Address - Phone:903-701-0007
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2012-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ23202084P0800X
TXW00836752084P0800X
TXBS34590422084P0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0802XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX86291GOtherTX BCBS PROVIDER#
TX117513503Medicaid
TX117513503Medicaid
TX8819K0Medicare ID - Type UnspecifiedMEDICARE PROVIDER#