1366918419 NPI number — HAROLD F. ADELMAN, M.D, PLLC

Table of content: (NPI 1366918419)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1366918419 NPI number — HAROLD F. ADELMAN, M.D, PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HAROLD F. ADELMAN, M.D, PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1366918419
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/16/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
P.O. BOX 2749
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GEORGETOWN
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78627
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
512-943-4585
Provider Business Mailing Address Fax Number:
512-943-4586

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3008 DAWN DRIVE
Provider Second Line Business Practice Location Address:
SUITE #103
Provider Business Practice Location Address City Name:
GEORGETOWN
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78628
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
512-943-4585
Provider Business Practice Location Address Fax Number:
512-943-4586
Provider Enumeration Date:
10/16/2018

Additional Information

Authorized Official

Authorized Official Last Name:
WYNN
Authorized Official First Name:
ANGELA
Authorized Official Middle Name:
Authorized Official Title or Position:
OFFICE MANAGER
Authorized Official Telephone Number:
512-943-4585

Provider Taxonomy Codes

  • Taxonomy code: 261QM0801X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0988265403 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com