Provider Demographics
NPI:1598309296
Name:SELVEY, FELICIA
Entity Type:Individual
Prefix:MRS
First Name:FELICIA
Middle Name:
Last Name:SELVEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2444 HAVERHILL DR
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75707-4400
Mailing Address - Country:US
Mailing Address - Phone:678-698-7375
Mailing Address - Fax:562-309-8477
Practice Address - Street 1:2444 HAVERHILL DR
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75707-4400
Practice Address - Country:US
Practice Address - Phone:678-698-7375
Practice Address - Fax:562-309-8477
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-05
Last Update Date:2019-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
No385H00000XRespite Care FacilityRespite Care