Healthcare Provider Details

I. General information

NPI: 1467620880
Provider Name (Legal Business Name): DAVID A. HOUGH PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/19/2008
Last Update Date: 09/24/2020
Certification Date: 09/24/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 NW 150TH ST STE A2
EDMOND OK
73013-3429
US

IV. Provider business mailing address

100 NW 150TH ST STE A2
EDMOND OK
73013-3429
US

V. Phone/Fax

Practice location:
  • Phone: 405-513-6465
  • Fax: 405-471-6477
Mailing address:
  • Phone: 405-513-6465
  • Fax: 405-471-6477

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number166
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: