1780914499 NPI number — MS. ELIZA CONE HOUGH PA-C

Table of content: MS. ELIZA CONE HOUGH PA-C (NPI 1780914499)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1780914499 NPI number — MS. ELIZA CONE HOUGH PA-C

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HOUGH
Provider First Name:
ELIZA
Provider Middle Name:
CONE
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
PA-C
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
CONE
Provider Other First Name:
ELIZA
Provider Other Middle Name:
ANNE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1780914499
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/30/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 751874
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CHARLOTTE
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28275-1874
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
843-402-5200
Provider Business Mailing Address Fax Number:
843-402-5296

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2085 HENRY TECKLENBURG DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CHARLESTON
Provider Business Practice Location Address State Name:
SC
Provider Business Practice Location Address Postal Code:
29414-7710
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
843-577-6957
Provider Business Practice Location Address Fax Number:
843-577-6523
Provider Enumeration Date:
12/31/2009

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: 363AM0700X , with the licence number:  1497 , registered in the state of SC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 5274PA , issued by the state of ( SC ) . This identifiers is of the category "MEDICAID".




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