Provider Demographics
NPI:1679640957
Name:STAHLMAN, ROBERT KECK II (DO)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:KECK
Last Name:STAHLMAN
Suffix:II
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:960 HIGHWAY 352
Mailing Address - Street 2:
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75149-6892
Mailing Address - Country:US
Mailing Address - Phone:214-391-2875
Mailing Address - Fax:
Practice Address - Street 1:960 HIGHWAY 352
Practice Address - Street 2:
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75149-6892
Practice Address - Country:US
Practice Address - Phone:214-391-2875
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2020-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF7194207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX097623503Medicaid
TX097623502Medicaid
TX097623503Medicaid
TX097623502Medicaid
TX8K6001Medicare PIN