Healthcare Provider Details

I. General information

NPI: 1053334466
Provider Name (Legal Business Name): SECKIN OMER ULUALP M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/26/2006
Last Update Date: 12/04/2023
Certification Date: 12/04/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1935 MEDICAL DISTRICT DR
DALLAS TX
75235-7701
US

IV. Provider business mailing address

5323 HARRY HINES BLVD
DALLAS TX
75390-9035
US

V. Phone/Fax

Practice location:
  • Phone: 214-456-2905
  • Fax:
Mailing address:
  • Phone: 214-648-2483
  • Fax: 214-648-6733

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License NumberFTL41421
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code207YP0228X
TaxonomyPediatric Otolaryngology Physician
License NumberT7757
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: