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General NPI Number Information
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NPI Number | 1619195195
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Entity Type | Individual
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Provider Name | MICHAEL SHAWN HOUSTON MD
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Gender | Male
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Dates
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Enumeration Date | 04/23/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | HWY 39
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City | LEXINGTON
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State | OK
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Zip | 73051
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Country | US
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Telephone | 405-527-5676
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Fax |
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Provider Business Mailing Address
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Address Line | 725 SW 156TH ST
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City | OKLAHOMA CITY
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State | OK
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Zip | 73170-7615
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Country | US
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Telephone | 405-703-3059
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Fax |
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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 | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 25279
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License Number State | OK
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