Healthcare Provider Details

I. General information

NPI: 1043320070
Provider Name (Legal Business Name): THOMAS P HOUSTON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 11/01/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3773 OLENTANGY RIVER RD
COLUMBUS OH
43214-3425
US

IV. Provider business mailing address

1299 OLENTANGY RIVER RD STE 103
COLUMBUS OH
43212-3140
US

V. Phone/Fax

Practice location:
  • Phone: 614-566-5356
  • Fax: 614-566-3835
Mailing address:
  • Phone: 614-566-4278
  • Fax: 614-566-5424

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number35046407
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: