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General NPI Number Information
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NPI Number | 1720937295
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Entity Type | Organization
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Legal Business Name | STRATEGIC MEDICAL GROUP TX PLLC
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Dates
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Enumeration Date | 01/27/2026
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Last Update Date | 01/27/2026
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Provider Practice Location Address
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Address Line | 909 SOUTHEAST PKWY STE 105
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City | AZLE
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State | TX
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Zip | 76020-3600
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Country | US
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Telephone | 817-238-0735
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Fax | 817-238-7327
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Provider Business Mailing Address
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Address Line | 4400 OAK PARK LN
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City | FORT WORTH
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State | TX
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Zip | 76109-9534
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Country | US
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Telephone | 617-985-7772
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Fax | 617-985-7772
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Authorized Official
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Title or Position | OWNER
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Name | OMAR F SELOD
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Credential |
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Telephone | 817-336-7188
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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