Healthcare Provider Details

I. General information

NPI: 1255866760
Provider Name (Legal Business Name): KELSEY MUSSELMAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/23/2017
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1801 INWOOD RD FL 6
DALLAS TX
75235-7202
US

IV. Provider business mailing address

1801 INWOOD RD FL 6
DALLAS TX
75235-7202
US

V. Phone/Fax

Practice location:
  • Phone: 214-392-6263
  • Fax:
Mailing address:
  • Phone: 410-933-6423
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberV6365
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number309036
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberD98150
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: