MEDICARE: DR. THOMAS JOEL HOUGEN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2080P0202X	Pediatric Cardiology Physician	0101045582	VA

General Provider Information

NPI Number	:	1245204353
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. THOMAS JOEL HOUGEN MD

Provider Business Mailing Address
First Line	:	11920 CRAGWOOD WAY
Second Line	:
City	:	POTOMAC
State	:	MD
Zip	:	20854-1201
Country	:	US
Telephone Number	:	301-299-8391
Fax Number	:	301-299-2795

Provider Business Practice Location Address
First Line	:	1625 N GEORGE MASON DR
Second Line	:	SUITE 405
City	:	ARLINGTON
State	:	VA
Zip	:	22205-3683
Country	:	US
Telephone Number	:	703-717-4070
Fax Number	:	703-717-4071

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/15/2006
Last Update Date	:	07/08/2007

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