Individual
KEVIN S HARBOURNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
500 W 4TH ST, ODESSA, TX 79761-5001
(432) 640-4000
Mailing address
2807 DANIEL MCCALL DR, APT. 314, LUFKIN, TX 75904-7150
(956) 466-5331
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
0101228721
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010193320
—
VA
01
—
8BG465
BCBS
TX
Enumeration date
02/09/2006
Last updated
07/11/2022
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