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Organization

CIVITAS CLINICAL SERVICES LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KELLY SELBY (OWNER/AUTHORIZED OFFICIAL)
(940) 220-5859
Entity
Organization

Contact information

Practice address
4400 TEASLEY LN # 400, DENTON, TX 76210-4650
(940) 220-5859
(940) 220-5859
Mailing address
6503 AUGUSTA NATIONAL DR, DENTON, TX 76210
(940) 220-5859
(940) 898-1986

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary

Other

Enumeration date
11/23/2021
Last updated
11/23/2021
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