Healthcare Provider Details

I. General information

NPI: 1023103603
Provider Name (Legal Business Name): STEPHEN C WESTMORELAND ED. D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3800 PALUXY DR STE 450
TYLER TX
75703-1659
US

IV. Provider business mailing address

PO BOX 8822
TYLER TX
75711-8822
US

V. Phone/Fax

Practice location:
  • Phone: 903-593-8395
  • Fax: 908-581-8679
Mailing address:
  • Phone: 903-593-8395
  • Fax: 903-581-8679

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number21579
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: