Provider Demographics
NPI:1245354125
Name:SELINA, PAUL GREGORY (MD)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:GREGORY
Last Name:SELINA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1415 NORTH LOOP W
Mailing Address - Street 2:SUITE 820
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77008-1664
Mailing Address - Country:US
Mailing Address - Phone:713-861-8200
Mailing Address - Fax:713-861-8261
Practice Address - Street 1:1415 NORTH LOOP W
Practice Address - Street 2:SUITE 820
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77008-1664
Practice Address - Country:US
Practice Address - Phone:713-861-8200
Practice Address - Fax:713-861-8261
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-18
Last Update Date:2011-10-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXK03772085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX044528002Medicaid
TXG34725Medicare UPIN
TX044528002Medicaid