MEDICARE: DAVID M. SABINE PH.D.

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	103T00000X	Psychologist	25041	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	121125	OTHER	TX	VALUEOPTIONS
3	00N17R	OTHER	TX	BLUE CROSS BLUE SHIELD
4	114618	OTHER	TX	SUPERIOR
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	130445	OTHER	TX	MHN
7	5052129	OTHER	TX	AETNA BEHAVIORAL HEALTH

General Provider Information

NPI Number	:	1659370849
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID M. SABINE PH.D.

Provider Business Mailing Address
First Line	:	4203 SHADY GROVE LN
Second Line	:
City	:	WICHITA FALLS
State	:	TX
Zip	:	76308-4459
Country	:	US
Telephone Number	:	940-228-7989
Fax Number	:	940-720-0018

Provider Business Practice Location Address
First Line	:	1708 DAYTON AVE
Second Line	:
City	:	WICHITA FALLS
State	:	TX
Zip	:	76301-6110
Country	:	US
Telephone Number	:	940-228-7989
Fax Number	:	940-720-0018

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/19/2005
Last Update Date	:	02/27/2025

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Directions to “ DAVID M. SABINE PH.D.” Practice Location

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