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General NPI Number Information
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NPI Number | 1235200304
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Entity Type | Individual
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Provider Name | JOHN W HOUSTON PT
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Gender | Male
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Dates
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Enumeration Date | 11/12/2006
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Last Update Date | 02/06/2020
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Provider Practice Location Address
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Address Line | 48 CAMELLIA RD
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City | CARRIERE
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State | MS
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Zip | 39426-7077
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Country | US
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Telephone | 601-798-7777
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Fax |
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Provider Business Mailing Address
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Address Line | 1620 HIGHWAY 11 N STE E
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City | PICAYUNE
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State | MS
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Zip | 39466-2070
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Country | US
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Telephone | 769-242-2626
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Fax | 769-242-2685
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT1533
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License Number State | MS
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