MEDICARE: REBECCA L HOUGH 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	174400000X	Specialist	M2654	TX
2	208000000X	Pediatrics Physician	M2654	TX

General Provider Information

NPI Number	:	1891773040
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REBECCA L HOUGH MD

Provider Business Mailing Address
First Line	:	PO BOX 4207
Second Line	:
City	:	LONGVIEW
State	:	TX
Zip	:	75606-4207
Country	:	US
Telephone Number	:	903-247-7700
Fax Number	:	903-238-9185

Provider Business Practice Location Address
First Line	:	705 E MARSHALL AVE
Second Line	:	SUITE 1002
City	:	LONGVIEW
State	:	TX
Zip	:	75601-5573
Country	:	US
Telephone Number	:	903-247-7700
Fax Number	:	903-238-9185

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

Provider Enumeration Date	:	01/06/2006
Last Update Date	:	06/18/2014

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Directions to “ REBECCA L HOUGH MD” Practice Location

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