Healthcare Provider Details

I. General information

NPI: 1689677056
Provider Name (Legal Business Name): MICHAEL R SEALS M.D. /P.A.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/31/2005
Last Update Date: 07/24/2024
Certification Date: 07/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6130 W PARKER RD MOB 1 STE 103
PLANO TX
75093-7901
US

IV. Provider business mailing address

PO BOX 117536
ATLANTA GA
30368-7536
US

V. Phone/Fax

Practice location:
  • Phone: 972-473-0190
  • Fax: 972-473-2257
Mailing address:
  • Phone: 615-346-8182
  • Fax: 615-829-8970

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberJ3901
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: