1952341208 NPI number — DR. GREGORY K HOUSTON I MD

Table of content: DR. GREGORY K HOUSTON I MD (NPI 1952341208)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1952341208 NPI number — DR. GREGORY K HOUSTON I MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HOUSTON
Provider First Name:
GREGORY
Provider Middle Name:
K
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
I
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1952341208
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/22/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7026 OLD KATY RD STE 276
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HOUSTON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77024-2187
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
713-621-7436
Provider Business Mailing Address Fax Number:
713-963-9051

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7026 OLD KATY RD STE 276
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77024-2187
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
713-621-7436
Provider Business Practice Location Address Fax Number:
713-963-9051
Provider Enumeration Date:
06/07/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2085R0204X , with the licence number:  G6185 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 10016824 . This is a "AMERIGROUP" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 300034176 . This is a "MEDICARE RAILROAD" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 00J245 . This is a "MEDICARE GROUP" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 124453503 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 083133101 . This is a "MEDICAID GROUP" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: CS7910 . This is a "MEDICARE RAILROAD GROUP" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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