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Organization

OMAR F SELOD DO PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. OMAR F SELOD DO (PRESIDENT)
(817) 336-7188
Entity
Organization

Contact information

Practice address
5632 EDWARDS RANCH RD STE 100, STE 506, FORT WORTH, TX 76109
(817) 336-7188
(817) 335-9039
Mailing address
P O BOX 678615, DALLAS, TX 75267-8615
(817) 336-7188
(817) 335-9039

Taxonomy

Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00154Q
BCBS
TX
05
145433201
TX
Enumeration date
03/15/2006
Last updated
06/16/2022
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