MEDICARE: JAMES EDWARD HOUCK JR.

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	3747P1801X	Personal Care Attendant		DC

General Provider Information

NPI Number	:	1982256988
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES EDWARD HOUCK JR.

Provider Business Mailing Address
First Line	:	1026 5TH ST NE
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20002-3534
Country	:	US
Telephone Number	:	202-830-4867
Fax Number	:

Provider Business Practice Location Address
First Line	:	1026 5TH ST NE
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20002-3534
Country	:	US
Telephone Number	:	202-830-4867
Fax Number	:	202-629-2331

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

Provider Enumeration Date	:	07/10/2019
Last Update Date	:	07/10/2019

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Directions to “ JAMES EDWARD HOUCK JR. ” Practice Location

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