MEDICARE: BO HOU

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	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	DF10645	MA
2	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	25977	TX

General Provider Information

NPI Number	:	1942516778
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BO HOU

Provider Business Mailing Address
First Line	:	211 HAYS CT
Second Line	:
City	:	COLLEYVILLE
State	:	TX
Zip	:	76034-7612
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2142 N COLLINS ST
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76011-2877
Country	:	US
Telephone Number	:	682-560-4486
Fax Number	:

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

Provider Enumeration Date	:	08/31/2010
Last Update Date	:	08/19/2019

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Directions to “ BO HOU ” Practice Location

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