MEDICARE: OSBORN PSYCHOLOGICAL SERVICES

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
2	103TC0700X	Clinical Psychologist

General Provider Information

NPI Number	:	1619765724
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OSBORN PSYCHOLOGICAL SERVICES

Provider Business Mailing Address
First Line	:	6464 SAN FELIPE ST APT 1205
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77057-2728
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6464 SAN FELIPE ST APT 1205
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77057-2728
Country	:	US
Telephone Number	:	832-515-5536
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. DANIEL PATRICK OSBORN
Credential	:	PHD
Telephone Number	:	832-515-5536

Provider Enumeration Date	:	04/28/2025
Last Update Date	:	04/28/2025

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