Healthcare Provider Details

I. General information

NPI: 1942204755
Provider Name (Legal Business Name): DAVID JOEL KORMAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2005
Last Update Date: 06/12/2025
Certification Date: 06/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

575 W HIGHWAY 243
CANTON TX
75103
US

IV. Provider business mailing address

2323 W FRONT ST
TYLER TX
75702-7747
US

V. Phone/Fax

Practice location:
  • Phone: 903-567-4197
  • Fax: 903-535-7384
Mailing address:
  • Phone: 903-597-1351
  • Fax: 903-535-7384

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberG5263
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: