Provider Demographics
NPI:1992828271
Name:ADELMAN, ROBERT W (PHD- PSYCHOLOGY)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:W
Last Name:ADELMAN
Suffix:
Gender:M
Credentials:PHD- PSYCHOLOGY
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 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
Is Sole Proprietor?:No
Enumeration Date:2007-04-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4251101Y00000X
TX31386103T00000X
TX3976106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101Y00000XBehavioral Health & Social Service ProvidersCounselor
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00252PMedicare ID - Type Unspecified