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Individual

DANIEL H KELLUM SR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
7323 MARBACH RD STE 104, SAN ANTONIO, TX 78227-1905
(210) 674-0257
(210) 369-9064
Mailing address
7323 MARBACH RD STE 104, SAN ANTONIO, TX 78227-1905
(210) 674-0257
(210) 369-9064

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
E2252
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00295N
MEDICARE GRP#
TX
01
1174518625
DANIEL H. KELLUM, SR, DO / NPI#
TX
01
1508813494
KELLUM MEDICAL GROUP, PA / NPI#
TX
01
193200000X
PRIMARY CARE GROUP TAXONOMY#
TX
01
207Q00000X
PROVIDER TAXONOMY#
TX
01
H2252
LICENSE#
TX
Enumeration date
09/12/2005
Last updated
03/09/2026
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