Provider Demographics
NPI:1508858085
Name:STULMAN, DAVID A (PHD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:A
Last Name:STULMAN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
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
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-19
Last Update Date:2008-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX21341103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX21341OtherSTATE PSYCHOLOGY LICENSE#
TX267 44990OtherMAR&FAMTHERAPY LICENSE #
TX83328PMedicare PIN
TX21341OtherSTATE PSYCHOLOGY LICENSE#