Provider Demographics
NPI:1578614004
Name:MICHAEL R SEALS MD, PA
Entity Type:Organization
Organization Name:MICHAEL R SEALS MD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:R
Authorized Official - Last Name:SEALS
Authorized Official - Suffix:
Authorized Official - Credentials:MD PA
Authorized Official - Phone:972-965-3855
Mailing Address - Street 1:PO BOX 117536
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30368-7536
Mailing Address - Country:US
Mailing Address - Phone:615-346-8182
Mailing Address - Fax:615-829-8970
Practice Address - Street 1:6130 W PARKER RD
Practice Address - Street 2:MOB 1 STE 103
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-7901
Practice Address - Country:US
Practice Address - Phone:972-965-3855
Practice Address - Fax:972-473-2257
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-12
Last Update Date:2021-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ3901174400000X, 2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Multi-Specialty
No174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX162317501Medicaid
TX0034KCOtherBCBS
TX0034KCOtherBCBS
TX162317501Medicaid