MEDICARE: DAVID HOUKE LMSW, LCDC

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	101YA0400X	Addiction (Substance Use Disorder) Counselor	6625	TX
2	104100000X	Social Worker	26111	TX

General Provider Information

NPI Number	:	1891142303
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID HOUKE LMSW, LCDC

Provider Business Mailing Address
First Line	:	3908 MOCHA TRL
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78728-3579
Country	:	US
Telephone Number	:	817-964-1997
Fax Number	:

Provider Business Practice Location Address
First Line	:	3908 MOCHA TRL
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78728-3579
Country	:	US
Telephone Number	:	817-964-1997
Fax Number	:

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

Provider Enumeration Date	:	05/16/2016
Last Update Date	:	05/16/2016

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