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NPI Code Detail

MEDICARE: DENNIS L. COBURN, PH.D. & ASSOCIATES

MEDICARE: DENNIS L. COBURN, PH.D. & ASSOCIATES
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
1103T00000XPsychologist21505TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1144340290
Entity Type Code : Organization
Provider Name (Legal Business Name) : DENNIS L. COBURN, PH.D. & ASSOCIATES
Provider Business Mailing Address
First Line : PO BOX 7338
Second Line :
City : THE WOODLANDS
State : TX
Zip : 77387-7338
Country : US
Telephone Number : 281-367-5664
Fax Number : 281-292-4018
Provider Business Practice Location Address
First Line : 4810 W PANTHER CREEK DR
Second Line : SUITE 100
City : THE WOODLANDS
State : TX
Zip : 77381-5008
Country : US
Telephone Number : 281-367-5664
Fax Number : 281-292-4018
Authorized Official
Title or Position : OWNER (PSYCHOLOGIST)
Name : DENNIS L COBURN
Credential : PH.D.
Telephone Number : 281-367-5664
Provider Enumeration Date : 03/30/2007
Last Update Date : 05/02/2017

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