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NPI Code Detail

MEDICARE: SELENA SMITH DPT

MEDICARE: SELENA SMITH DPT
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
1225100000XPhysical Therapist

General Provider Information

NPI Number : 1881238574
Entity Type Code : Individual
Provider Name (Legal Business Name) : SELENA SMITH DPT
Provider Business Mailing Address
First Line : PO BOX 909
Second Line :
City : SUMMIT
State : MS
Zip : 39666-0909
Country : US
Telephone Number : 504-442-6498
Fax Number :
Provider Business Practice Location Address
First Line : 13031 WORTHAM CENTER DR
Second Line :
City : HOUSTON
State : TX
Zip : 77065-5662
Country : US
Telephone Number : 832-280-2500
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/05/2019
Last Update Date : 02/02/2024

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