Individual
KEVIN E HOUSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
55 LAKE AVE N, WORCESTER, MA 01655-0002
(508) 334-2527
(774) 442-3687
Mailing address
PO BOX 415348, BOSTON, MA 02241-5348
(800) 225-8885
(508) 334-1977
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
002153
GA
152W00000X
Optometrist
18003242
IN
152W00000X
Optometrist
Primary
4864
MA
152WL0500X
Low Vision Rehabilitation Optometrist
4864
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
283816526A
—
IN
Enumeration date
02/05/2007
Last updated
01/13/2023
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