Provider Demographics
NPI:1821181918
Name:KELFER, HOWARD M (MD)
Entity type:Individual
Prefix:
First Name:HOWARD
Middle Name:M
Last Name:KELFER
Suffix:
Gender:M
Credentials:MD
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 733784
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75373-3784
Mailing Address - Country:US
Mailing Address - Phone:682-885-1855
Mailing Address - Fax:682-885-1396
Practice Address - Street 1:1500 COOPER ST
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76104-2710
Practice Address - Country:US
Practice Address - Phone:682-885-2500
Practice Address - Fax:682-885-2510
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2023-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG24092084N0402X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0402XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology with Special Qualifications in Child Neurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX023247201Medicaid
TX137042106Medicaid
TX140442803Medicaid
1750369203OtherGRP NPI NUMBER
TX1640331OtherFIRSTHEALTH PIN
TX112785OtherSUPERIOR PIN
TX413466OtherPHCS PIN
TX116569100OtherFIRSTCARE PIN
TX10028599OtherAMERIGROUP PIN
TX4092527OtherAETNA PIN
TX00U87ZOtherBCBSTX GRP PIN
TX1392749OtherUHC PIN
TX7997205OtherCIGNA PIN
TX87V780OtherBCBSTX IND PIN
TX137042105Medicaid
TX137042105Medicaid
TX00L98SMedicare PIN
TX116569100OtherFIRSTCARE PIN