Healthcare Provider Details

I. General information

NPI: 1811979958
Provider Name (Legal Business Name): ANGELA G HOUSER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANGELA G CHRISTMAN MD

II. Dates (important events)

Enumeration Date: 11/15/2005
Last Update Date: 06/09/2020
Certification Date: 06/09/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

37 MEDICAL CROSSING ROAD
TAMAQUA PA
18252
US

IV. Provider business mailing address

37 MEDICAL CROSSING ROAD
TAMAQUA PA
18252
US

V. Phone/Fax

Practice location:
  • Phone: 570-386-5926
  • Fax: 570-386-2959
Mailing address:
  • Phone: 570-386-5926
  • Fax: 570-386-2959

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberMD050532L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: