MEDICARE: MATTHEW AARON HOUCK O.D.

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	152W00000X	Optometrist	082831	IA

General Provider Information

NPI Number	:	1942658455
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MATTHEW AARON HOUCK O.D.

Provider Business Mailing Address
First Line	:	172 HAWKEYE CT APT 211
Second Line	:
City	:	IOWA CITY
State	:	IA
Zip	:	52246-2859
Country	:	US
Telephone Number	:	765-714-0636
Fax Number	:

Provider Business Practice Location Address
First Line	:	1614 SYCAMORE ST
Second Line	:
City	:	IOWA CITY
State	:	IA
Zip	:	52240-6044
Country	:	US
Telephone Number	:	319-337-3737
Fax Number	:

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

Provider Enumeration Date	:	05/25/2016
Last Update Date	:	05/25/2016

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