Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0505X | Family Doctor - Adult Medicine | 9383 | OK |
NPI | 1154342988 |
---|---|
Provider Name | Dr. Robert Alan Houston |
First Address | Tulsa, OK 74105-2757 |
Second Address | Tulsa, OK 74110-5323 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/07/2006 |
Last Update Date | 08/07/2007 |