Individual ProviderKody SelzerFamily MedicineAllopathic & Osteopathic PhysiciansPractice Address1500 S Main St, Fort Worth, TX 76104-4917(817) 702-3431PECOS EnrollmentBased on the most recent information from CMS, provider Kody Selzer is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 3 days ago.Profile DetailsProvider ID1265894323Provider TypeIndividualFull NameSelzer, KodyCredentialM.D.GenderMaleSole ProprietorNoEnumeration Date3/27/2016Last Updated4/7/2020Contact InformationPractice LocationPractice Address1500 S Main St, Fort Worth, TX 76104-4917Phone(817) 702-3431FaxUnlisted FaxMailing LocationMailing Address1500 S Main St, Fort Worth, TX 76104-4917Phone(817) 702-3431FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode207Q00000XPrimaryDescriptionFamily MedicineAllopathic & Osteopathic PhysiciansLicenseR5036TexasProvider IdentifiersIDDescriptionIssuerIDR5036DescriptionOtherIssuerMEDICAL STATE LICENSETexas