Individual
DR. SIDNEY A KELT JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3500 OAKLAWN AVE, STE 300, DALLAS, TX 75219-4349
(972) 709-1961
Mailing address
3500 OAKLAWN AVE, STE 300, DALLAS, TX 75219-4349
(972) 709-1961
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
H1601
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A32X
BCBS PROVIDER #
TX
05
—
113854702
—
TX
01
—
752484883
TAX ID #
TX
Enumeration date
05/10/2006
Last updated
12/19/2023
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