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NPI Code Detail

MEDICARE: STRATEGIC MEDICAL GROUP TX PLLC

MEDICARE: STRATEGIC MEDICAL GROUP TX PLLC
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
1261QP2300XPrimary Care Clinic/Center

General Provider Information

NPI Number : 1700735271
Entity Type Code : Organization
Provider Name (Legal Business Name) : STRATEGIC MEDICAL GROUP TX PLLC
Provider Business Mailing Address
First Line : 4400 OAK PARK LN
Second Line :
City : FORT WORTH
State : TX
Zip : 76109-9534
Country : US
Telephone Number : 817-985-7772
Fax Number :
Provider Business Practice Location Address
First Line : 141 INDUSTRIAL AVE
Second Line :
City : AZLE
State : TX
Zip : 76020-2901
Country : US
Telephone Number : 817-444-3231
Fax Number :
Authorized Official
Title or Position : OWNER
Name : OMAR SELOD
Credential : MD
Telephone Number : 817-203-4057
Provider Enumeration Date : 01/27/2026
Last Update Date : 01/27/2026

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Directions to “STRATEGIC MEDICAL GROUP TX PLLC ” Practice Location

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