Provider Demographics
NPI:1366918419
Name:HAROLD F. ADELMAN, M.D, PLLC
Entity type:Organization
Organization Name:HAROLD F. ADELMAN, M.D, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:
Authorized Official - Last Name:WYNN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-943-4585
Mailing Address - Street 1:P.O. BOX 2749
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:TX
Mailing Address - Zip Code:78627
Mailing Address - Country:US
Mailing Address - Phone:512-943-4585
Mailing Address - Fax:512-943-4586
Practice Address - Street 1:3008 DAWN DRIVE
Practice Address - Street 2:SUITE #103
Practice Address - City:GEORGETOWN
Practice Address - State:TX
Practice Address - Zip Code:78628
Practice Address - Country:US
Practice Address - Phone:512-943-4585
Practice Address - Fax:512-943-4586
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-16
Last Update Date:2018-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0988265403Medicaid