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General NPI Number Information
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NPI Number | 1689794554
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Entity Type | Organization
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Legal Business Name | HARVEY J DURBIN JR.
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Dates
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Enumeration Date | 04/02/2007
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Last Update Date | 09/03/2010
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Provider Practice Location Address
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Address Line | 855 CENTRAL DR STE 31B
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City | ODESSA
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State | TX
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Zip | 79761-4246
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Country | US
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Telephone | 432-550-9208
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Fax | 432-550-0139
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Provider Business Mailing Address
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Address Line | PO BOX 60104
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City | MIDLAND
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State | TX
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Zip | 79711-0104
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Country | US
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Telephone | 432-550-9208
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Fax | 432-550-0139
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Authorized Official
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Title or Position | CLINICAL PSYCHOLOGIST
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Name | DR. HARVEY J DURBIN JR.
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Credential | PH.D.
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Telephone | 432-550-9208
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 21610
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License Number State | TX
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