Individual
STEVEN A LOGSDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D
Contact information
Practice address
433 KITTY HAWK RD, STE 219, UNIVERSAL CITY, TX 78148-3829
(210) 658-6410
(210) 531-7334
Mailing address
PO BOX 2607, UNIVERSAL CITY, TX 78148-1607
(210) 658-6410
(210) 531-7334
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
22560
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0976953-01
—
TX
01
—
22560
TEXAS STATE LICENSE
TX
Enumeration date
11/03/2006
Last updated
11/25/2016
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