Healthcare Provider Details

I. General information

NPI: 1295187029
Provider Name (Legal Business Name): HOU-XUAN HUANG M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/05/2016
Last Update Date: 04/12/2022
Certification Date: 04/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1405 CLIFTON RD NE
ATLANTA GA
30322-0001
US

IV. Provider business mailing address

2015 UPPERGATE DRIVE 5TH FLOOR
ATLANTA GA
30322-1015
US

V. Phone/Fax

Practice location:
  • Phone: 608-886-7429
  • Fax:
Mailing address:
  • Phone:
  • Fax: 262-208-1403

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number6539851
License Number StateWI
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number83064
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: