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General NPI Number Information
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NPI Number | 1942353354
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Entity Type | Individual
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Provider Name | PHILIP RAY BUDD PSY.D.
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Gender | Male
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Dates
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Enumeration Date | 01/19/2007
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Last Update Date | 10/20/2020
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Provider Practice Location Address
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Address Line | 16301 SONOMA PARK DRIVE
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City | EDMOND
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State | OK
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Zip | 73003
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Country | US
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Telephone | 405-246-5433
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Fax |
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Provider Business Mailing Address
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Address Line | 6729 NW 39TH EXPY
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City | BETHANY
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State | OK
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Zip | 73008-2605
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Country | US
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Telephone | 405-491-6656
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Fax | 405-491-6375
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 741
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License Number State | OK
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