Provider Demographics
NPI:1689794554
Name:HARVEY J DURBIN JR.
Entity Type:Organization
Organization Name:HARVEY J DURBIN JR.
Other - Org Name:ABMP CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:HARVEY
Authorized Official - Middle Name:J
Authorized Official - Last Name:DURBIN
Authorized Official - Suffix:JR
Authorized Official - Credentials:PHD
Authorized Official - Phone:432-550-9208
Mailing Address - Street 1:PO BOX 60104
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79711-0104
Mailing Address - Country:US
Mailing Address - Phone:432-550-9208
Mailing Address - Fax:432-550-0139
Practice Address - Street 1:855 CENTRAL DR STE 31B
Practice Address - Street 2:
Practice Address - City:ODESSA
Practice Address - State:TX
Practice Address - Zip Code:79761-4246
Practice Address - Country:US
Practice Address - Phone:432-550-9208
Practice Address - Fax:432-550-0139
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-02
Last Update Date:2010-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX21610103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX085831801Medicaid
TXR44802Medicare UPIN
TX81768PMedicare PIN
TX00U96MMedicare PIN