Provider Demographics
NPI:1831186543
Name:SEPDHAM, DAN (MD)
Entity type:Individual
Prefix:
First Name:DAN
Middle Name:
Last Name:SEPDHAM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:5323 HARRY HINES BLVD
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75390-7201
Mailing Address - Country:US
Mailing Address - Phone:214-648-6524
Mailing Address - Fax:214-645-0078
Practice Address - Street 1:5323 HARRY HINES BLVD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75390-9067
Practice Address - Country:US
Practice Address - Phone:682-777-5870
Practice Address - Fax:214-645-0078
Is Sole Proprietor?:No
Enumeration Date:2005-09-29
Last Update Date:2025-06-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXK7478207Q00000X, 207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine