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General NPI Number Information
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NPI Number | 1245204353
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Entity Type | Individual
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Provider Name | THOMAS JOEL HOUGEN MD
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Gender | Male
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Dates
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Enumeration Date | 02/15/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1625 N GEORGE MASON DR SUITE 405
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City | ARLINGTON
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State | VA
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Zip | 22205-3683
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Country | US
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Telephone | 703-717-4070
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Fax | 703-717-4071
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Provider Business Mailing Address
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Address Line | 11920 CRAGWOOD WAY
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City | POTOMAC
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State | MD
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Zip | 20854-1201
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Country | US
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Telephone | 301-299-8391
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Fax | 301-299-2795
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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 | 2080P0202X
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Taxonomy Name | Pediatric Cardiology Physician
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License Number | 0101045582
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License Number State | VA
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