MEDICARE: STEPHEN HOWARD PHD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	15831	TX

General Provider Information

NPI Number	:	1184913816
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHEN HOWARD PHD

Provider Business Mailing Address
First Line	:	PO BOX 675
Second Line	:
City	:	KELLER
State	:	TX
Zip	:	76244-0675
Country	:	US
Telephone Number	:	817-471-6222
Fax Number	:

Provider Business Practice Location Address
First Line	:	3509 HULEN ST
Second Line	:	SUITE 100
City	:	FORT WORTH
State	:	TX
Zip	:	76107-6862
Country	:	US
Telephone Number	:	817-471-6222
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/04/2011
Last Update Date	:	04/04/2011

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