Individual
DR. BRADLEY L HOUSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
701 HEWITT BLVD, RED WING, MN 55066-2848
(651) 267-5000
Mailing address
PO BOX 850, PORT ANGELES, WA 98362-0146
(360) 565-9237
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
72960
MN
207Q00000X
Family Medicine Physician
MD60758090
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036101327
—
IL
Enumeration date
09/23/2005
Last updated
02/08/2023
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