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General NPI Number Information
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NPI Number | 1922266097
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Entity Type | Organization
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Legal Business Name | INDAL M SEUDEAL MDPA
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Dates
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Enumeration Date | 05/27/2008
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Last Update Date | 01/31/2014
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Provider Practice Location Address
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Address Line | 1300 E HARRISON AVE
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City | HARLINGEN
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State | TX
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Zip | 78550-7130
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Country | US
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Telephone | 956-428-7482
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Fax | 956-428-7544
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Provider Business Mailing Address
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Address Line | PO BOX 324
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City | RIO HONDO
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State | TX
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Zip | 78583-0324
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Country | US
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Telephone | 956-428-7482
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Fax | 956-428-7544
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Authorized Official
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Title or Position | DOCTOR
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Name | INDAL SEUDEAL
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Credential | MD
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Telephone | 956-428-7482
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number |
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License Number State | TX
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