MEDICARE: LARRY WAYNE HOUK M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician	19072	OK

General Provider Information

NPI Number	:	1316987183
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LARRY WAYNE HOUK M.D.

Provider Business Mailing Address
First Line	:	5300 N INDEPENDENCE AVE
Second Line	:	280
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73112-5556
Country	:	US
Telephone Number	:	405-945-5275
Fax Number	:	405-945-5232

Provider Business Practice Location Address
First Line	:	3435 NW 56TH ST STE 1010
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73112-4442
Country	:	US
Telephone Number	:	405-945-5275
Fax Number	:	405-945-5232

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/08/2006
Last Update Date	:	01/13/2020

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