Provider Demographics
NPI:1275638983
Name:SELZER, ANJANETTE MOORE (MD)
Entity Type:Individual
Prefix:
First Name:ANJANETTE
Middle Name:MOORE
Last Name:SELZER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ANJANETTE
Other - Middle Name:RAE
Other - Last Name:MOORE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:230 N RUFE SNOW DR
Mailing Address - Street 2:
Mailing Address - City:KELLER
Mailing Address - State:TX
Mailing Address - Zip Code:76248-4226
Mailing Address - Country:US
Mailing Address - Phone:817-337-5503
Mailing Address - Fax:
Practice Address - Street 1:230 N RUFE SNOW DR
Practice Address - Street 2:
Practice Address - City:KELLER
Practice Address - State:TX
Practice Address - Zip Code:76248-4226
Practice Address - Country:US
Practice Address - Phone:817-337-5503
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2012-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM3652208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
1003887985OtherGRP NPI NUMBER
TX149525100OtherFIRSTCARE PIN
TX179287103Medicaid
TX0087LEOtherBCBSTX GRP PIN
TX170994101Medicaid
TX179287102Medicaid
TX080626701Medicaid
TX8W0350OtherBCBSTX IND PIN
TX8690180OtherCIGNA PIN
TXB72777OtherPRONET PIN
TX9409157OtherPHCS PIN
TX0087LEOtherBCBSTX GRP PIN