Provider Demographics
NPI:1366403594
Name:DAVID A. STULMAN, PH.D., P.C.
Entity type:Organization
Organization Name:DAVID A. STULMAN, PH.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:A
Authorized Official - Last Name:STULMAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:254-634-3007
Mailing Address - Street 1:PO BOX 1343
Mailing Address - Street 2:
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76540-1343
Mailing Address - Country:US
Mailing Address - Phone:254-634-3007
Mailing Address - Fax:254-634-3280
Practice Address - Street 1:2100 TRIMMIER RD
Practice Address - Street 2:SUITE 103
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76541-8900
Practice Address - Country:US
Practice Address - Phone:254-634-3007
Practice Address - Fax:254-634-3280
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-29
Last Update Date:2008-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2-1341103T00000X, 103TC1900X
TX267 44990106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Multi-Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX21341OtherSTATE PSYCHOLOGY LICENSE
TX267 44990OtherMAR&FAM THERAPY LICENSE #
TX267 44990OtherMAR&FAM THERAPY LICENSE #