Provider Demographics
NPI:1891985537
Name:SELECT SENIOR CLINICS OF TEXAS,LLC
Entity Type:Organization
Organization Name:SELECT SENIOR CLINICS OF TEXAS,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TREVOR
Authorized Official - Middle Name:
Authorized Official - Last Name:RABIE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-234-7384
Mailing Address - Street 1:12221 S KIRKWOOD RD STE 100
Mailing Address - Street 2:
Mailing Address - City:MEADOWS PLACE
Mailing Address - State:TX
Mailing Address - Zip Code:77477-3017
Mailing Address - Country:US
Mailing Address - Phone:713-234-7384
Mailing Address - Fax:713-234-7386
Practice Address - Street 1:12221 S KIRKWOOD RD
Practice Address - Street 2:SUITE 100
Practice Address - City:MEADOWS PLACE
Practice Address - State:TX
Practice Address - Zip Code:77477-3044
Practice Address - Country:US
Practice Address - Phone:713-234-7384
Practice Address - Fax:713-234-7386
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-30
Last Update Date:2009-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty