Individual
MR. HEROLD SCOTT OSBORNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A-C
Contact information
Practice address
3535 N FOURTH ST STE 400, LONGVIEW, TX 75605-0038
(903) 757-3881
(903) 757-5948
Mailing address
3535 N FOURTH ST STE 400, LONGVIEW, TX 75605-0038
(903) 757-3881
(903) 757-5948
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA01750
TX
363AM0700X
Medical Physician Assistant
Primary
PA01750
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8L27392
MEDICARE INDIVIDUAL PIN
TX
01
—
PA01750
STATE PA LICENSE
TX
Enumeration date
08/12/2006
Last updated
03/03/2021
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