Provider Demographics
NPI:1306204599
Name:MCCONATHY, SEAN ADAM (DC)
Entity type:Individual
Prefix:DR
First Name:SEAN
Middle Name:ADAM
Last Name:MCCONATHY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1421 BRANARD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77006
Mailing Address - Country:US
Mailing Address - Phone:254-314-0670
Mailing Address - Fax:
Practice Address - Street 1:1421 BRANARD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77006
Practice Address - Country:US
Practice Address - Phone:254-314-0670
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-03
Last Update Date:2016-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13095111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor