Organization · NPI-2

Angela D Self MD

Internal Medicine · North Richland Hills, TX

NPI number1104023134
StatusActive
Last updated in NPPESJul 10, 2007

Details

NPI
1104023134
Entity type
Organization (NPI-2)
Legal business name
Angela D Self MD
Organization subpart
No
Enumeration date
Jul 2, 2007
Last updated
Jul 10, 2007

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207R00000X Internal Medicine––Yes

Practice location

5409 Davis Blvd
North Richland Hills, TX 76180-6827

Phone 817-788-1059 · Fax 817-581-1065

Mailing address

5409 Davis Blvd
North Richland Hills, TX 76180-6827

Phone 817-788-1059 · Fax 817-581-1065

Authorized official

Angela D Self
Owner
8177881059

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