Provider Demographics
NPI:1194235358
Name:OSTEEN, ENNIS DWIGHT II (RPSGT)
Entity type:Individual
Prefix:MR
First Name:ENNIS
Middle Name:DWIGHT
Last Name:OSTEEN
Suffix:II
Gender:M
Credentials:RPSGT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20834 DEAUVILLE DR
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77388-4149
Mailing Address - Country:US
Mailing Address - Phone:866-750-1161
Mailing Address - Fax:866-750-1161
Practice Address - Street 1:1310 RAYFORD RD STE 203
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77386-2613
Practice Address - Country:US
Practice Address - Phone:866-750-1161
Practice Address - Fax:866-750-1161
Is Sole Proprietor?:No
Enumeration Date:2017-10-02
Last Update Date:2017-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2472E0500XTechnologists, Technicians & Other Technical Service ProvidersTechnician, OtherEEG