Provider Demographics
NPI:1033548755
Name:STEPHEN M. OSBORN, PH.D., P.C.
Entity Type:Organization
Organization Name:STEPHEN M. OSBORN, PH.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:OSBORN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:325-695-2232
Mailing Address - Street 1:4601 BUFFALO GAP RD.
Mailing Address - Street 2:SUITE C-6
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79606
Mailing Address - Country:US
Mailing Address - Phone:325-695-2232
Mailing Address - Fax:325-695-2233
Practice Address - Street 1:4601 BUFFALO GAP RD
Practice Address - Street 2:SUITE C-6
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79606-3375
Practice Address - Country:US
Practice Address - Phone:325-695-2232
Practice Address - Fax:325-695-2233
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-04
Last Update Date:2013-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX22414261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center