Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080A0000X | Adolescent Medicine | D63288 | MD |
NPI | 1013951300 |
---|---|
Provider Name | Avril M Houston |
First Address | Rockville, MD 20857 |
Second Address | Rockville, MD 20857 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/06/2006 |
Last Update Date | 28/12/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
434207101 | (05) | MD |
H62833 | (02) |