Provider Demographics
NPI:1427256775
Name:ROBERT W ADELMAN ET AL PTR KELMAN AND ASSOCIATES
Entity type:Organization
Organization Name:ROBERT W ADELMAN ET AL PTR KELMAN AND ASSOCIATES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:MS
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:K
Authorized Official - Last Name:KELMAN
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:903-874-8442
Mailing Address - Street 1:PO BOX 860
Mailing Address - Street 2:
Mailing Address - City:MALAKOFF
Mailing Address - State:TX
Mailing Address - Zip Code:75148-0860
Mailing Address - Country:US
Mailing Address - Phone:903-874-8442
Mailing Address - Fax:903-489-0712
Practice Address - Street 1:803 W 2ND AVE
Practice Address - Street 2:
Practice Address - City:CORSICANA
Practice Address - State:TX
Practice Address - Zip Code:75110-2947
Practice Address - Country:US
Practice Address - Phone:903-874-8442
Practice Address - Fax:903-489-0712
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-09
Last Update Date:2009-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4251101YP2500X
TX12019101YP2500X
TX31386103T00000X
TX3976106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0954158-03Medicaid
TX0263246-01Medicaid
TX00252PMedicare PIN