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General NPI Number Information
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NPI Number | 1548219124
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Entity Type | Individual
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Provider Name | LANNING HOUSTON M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/09/2006
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Last Update Date | 04/25/2019
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Provider Practice Location Address
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Address Line | 250 THOMPSON ST
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City | SAINT PAUL
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State | MN
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Zip | 55102-2370
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Country | US
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Telephone | 651-292-2000
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Fax | 651-292-2136
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Provider Business Mailing Address
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Address Line | 4801 W 81ST ST SUITE 108
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City | BLOOMINGTON
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State | MN
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Zip | 55437-1111
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Country | US
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Telephone | 952-837-9700
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Fax | 952-837-9701
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 30261
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License Number State | MN
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