Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | E1198 | TX |
N | 207ND0101X | MOHS-Micrographic Surgeon | E1198 | TX |
N | 207NS0135X | Procedural Dermatology | E1198 | TX |
NPI | 1548235633 |
---|---|
Provider Name | Dr. Stephen Douglas Houston |
First Address | Austin, TX 78745-1686 |
Second Address | Austin, TX 78745-1686 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/02/2006 |
Last Update Date | 19/04/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
122735702 | (05) | TX |
H0082W090 | (02) | TX |