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NPI Code Detail

MEDICARE: THOMAS C SELVAGGI M.D.

MEDICARE: THOMAS C SELVAGGI M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine PhysicianH0803TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1255326393
Entity Type Code : Individual
Provider Name (Legal Business Name) : THOMAS C SELVAGGI M.D.
Provider Business Mailing Address
First Line : 4215 JOE RAMSEY BLVD E
Second Line :
City : GREENVILLE
State : TX
Zip : 75401-7852
Country : US
Telephone Number : 903-408-5834
Fax Number : 903-408-5693
Provider Business Practice Location Address
First Line : 1705 LIVE OAK ST
Second Line :
City : COMMERCE
State : TX
Zip : 75428-2551
Country : US
Telephone Number : 903-886-8818
Fax Number : 903-886-8765
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/14/2005
Last Update Date : 04/30/2026

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Directions to “ THOMAS C SELVAGGI M.D.” Practice Location

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