Organization
ANGELA D SELF MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANGELA D SELF MD (OWNER)
(817) 788-1059
Entity
Organization
Contact information
Practice address
5409 DAVIS BLVD, NORTH RICHLAND HILLS, TX 76180-6827
(817) 788-1059
(817) 581-1065
Mailing address
5409 DAVIS BLVD, NORTH RICHLAND HILLS, TX 76180-6827
(817) 788-1059
(817) 581-1065
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0043KL
BLUE CROSS BLUE SHIELD
TX
Enumeration date
07/02/2007
Last updated
07/10/2007
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