Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0007X | Plastic Surgeon (Head & Neck) | L8501 | TX |
NPI | 1669468849 |
---|---|
Provider Name | Peter Selz |
First Address | Denison, TX 75020-2079 |
Second Address | Sherman, TX 75092-6374 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/09/2005 |
Last Update Date | 29/04/2021 |