Basic Information
Provider Information
NPI: 1982137873
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SEIBERT
FirstName: ADAM
MiddleName: RICHARD
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 7703 FLOYD CURL DR
Address2: DEPARTMENT OF ANESTHESIOLOGY, MAIL CODE 7838
City: SAN ANTONIO
State: TX
PostalCode: 782293900
CountryCode: US
TelephoneNumber: 2105674500
FaxNumber:  
Practice Location
Address1: 7703 FLOYD CURL DR
Address2:  
City: SAN ANTONIO
State: TX
PostalCode: 78229
CountryCode: US
TelephoneNumber: 2105675711
FaxNumber: 2105672347
Other Information
ProviderEnumerationDate: 04/06/2017
LastUpdateDate: 06/08/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 06/08/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208600000XBP10062968TXN Allopathic & Osteopathic PhysiciansSurgery 
390200000X  N Student, Health CareStudent in an Organized Health Care Education/Training Program 
207L00000XBP10062968TXY Allopathic & Osteopathic PhysiciansAnesthesiology 

No ID Information.


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