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General NPI Number Information
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NPI Number | 1538693130
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Entity Type | Individual
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Provider Name | BARBARA SELMON
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Gender | Female
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Dates
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Enumeration Date | 04/20/2017
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Last Update Date | 04/20/2017
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Provider Practice Location Address
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Address Line | 5522 GRAND LAKE ST
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City | BELLAIRE
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State | TX
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Zip | 77401-4834
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Country | US
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Telephone | 713-429-4919
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Fax | 713-665-3123
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Provider Business Mailing Address
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Address Line | 5522 GRAND LAKE ST
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City | BELLAIRE
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State | TX
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Zip | 77401-4834
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 405300000X
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Taxonomy Name | Prevention Professional
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License Number | MT104191
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License Number State | TX
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