Healthcare Provider Details

I. General information

NPI: 1346220506
Provider Name (Legal Business Name): ROBERT MICHAEL SELVESTER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/21/2006
Last Update Date: 09/09/2021
Certification Date: 09/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5005 E CROSSTIMBERS ST
HOUSTON TX
77016-6301
US

IV. Provider business mailing address

1395 NW 167TH ST
MIAMI GARDENS FL
33169-5710
US

V. Phone/Fax

Practice location:
  • Phone: 832-709-2770
  • Fax:
Mailing address:
  • Phone: 832-709-2770
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberT2267
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: