Provider Demographics
NPI:1346404258
Name:SELASSIE, RAHEL (MD)
Entity Type:Individual
Prefix:
First Name:RAHEL
Middle Name:
Last Name:SELASSIE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3215 CLOVERLEAF CT
Mailing Address - Street 2:
Mailing Address - City:MANVEL
Mailing Address - State:TX
Mailing Address - Zip Code:77578-7824
Mailing Address - Country:US
Mailing Address - Phone:832-818-5108
Mailing Address - Fax:
Practice Address - Street 1:1709 DRYDEN RD STE 1700
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2504
Practice Address - Country:US
Practice Address - Phone:713-798-5117
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-10
Last Update Date:2012-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP10030731207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology