Individual
RICHARD HESTON SEIDEL JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1720 SOUTH BECKHAM AVE, TYLER, TX 75701
(903) 595-5101
(903) 597-2314
Mailing address
1720 SOUTH BECKHAM AVE, TYLER, TX 75701
(903) 595-5101
(903) 597-2314
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
J4508
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100011163
RAIL ROAD MEDICARE
TX
05
—
104033903
—
TX
05
—
104033907
—
TX
01
—
75-2616977-008
TRICARE
TX
01
—
75-2616977-054
TRICARE
TX
01
—
75-2616977-125
TRICARE
TX
01
—
8GC765
BCBS
TX
Enumeration date
08/15/2006
Last updated
04/21/2017
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