Provider Demographics
NPI:1699738286
Name:SEIDMEYER, VICKI LYNN (DO)
Entity type:Individual
Prefix:DR
First Name:VICKI
Middle Name:LYNN
Last Name:SEIDMEYER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1620 N HARDIN BLVD STE 2000
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75071-3569
Mailing Address - Country:US
Mailing Address - Phone:945-234-6211
Mailing Address - Fax:945-234-6212
Practice Address - Street 1:1620 N HARDIN BLVD STE 2000
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75071-3569
Practice Address - Country:US
Practice Address - Phone:945-234-6211
Practice Address - Fax:945-234-6212
Is Sole Proprietor?:No
Enumeration Date:2006-04-06
Last Update Date:2024-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK0376207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX121324103Medicaid
TX00067LMedicare ID - Type Unspecified
TX121324103Medicaid