Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0300X | Geriatric Medicine | 40996 | GA |
N | 207RH0002X | Hospice and Palliative Medicine | K6309 | TX |
NPI | 1235154204 |
---|---|
Provider Name | Dr. Senthilnathan Selvaraj |
First Address | Waco, TX 76711 |
Second Address | Waco, TX 76711-1329 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/07/2006 |
Last Update Date | 13/05/2013 |