Provider Demographics
NPI:1922266097
Name:INDAL M SEUDEAL MDPA
Entity Type:Organization
Organization Name:INDAL M SEUDEAL MDPA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:INDAL
Authorized Official - Middle Name:
Authorized Official - Last Name:SEUDEAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:956-428-7482
Mailing Address - Street 1:PO BOX 324
Mailing Address - Street 2:
Mailing Address - City:RIO HONDO
Mailing Address - State:TX
Mailing Address - Zip Code:78583-0324
Mailing Address - Country:US
Mailing Address - Phone:956-428-7482
Mailing Address - Fax:956-428-7544
Practice Address - Street 1:1300 E HARRISON AVE
Practice Address - Street 2:
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78550-7130
Practice Address - Country:US
Practice Address - Phone:956-428-7482
Practice Address - Fax:956-428-7544
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-27
Last Update Date:2014-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00116ZMedicare PIN