MEDICARE: MS. MARY AUGER HOUSTON PA-C

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	363A00000X	Physician Assistant
2	363A00000X	Physician Assistant	0110003885	VA

General Provider Information

NPI Number	:	1447480355
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MARY AUGER HOUSTON PA-C

Provider Business Mailing Address
First Line	:	1506 N KENILWORTH ST
Second Line	:
City	:	ARLINGTON
State	:	VA
Zip	:	22205-2821
Country	:	US
Telephone Number	:	919-440-2035
Fax Number	:

Provider Business Practice Location Address
First Line	:	200 N GLEBE RD STE 300
Second Line	:
City	:	ARLINGTON
State	:	VA
Zip	:	22203-3755
Country	:	US
Telephone Number	:	703-243-1300
Fax Number	:

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

Provider Enumeration Date	:	07/27/2009
Last Update Date	:	06/26/2021

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