Individual
DR. PEAESHA LYNETTE HOUSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
4445 S LEE ST STE 105, BUFORD, GA 30518-8806
(770) 848-9240
Mailing address
PO BOX 742616, ATLANTA, GA 30374-2616
(770) 219-8420
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
78196
GA
390200000X
Student in an Organized Health Care Education/Training Program
6754
GA
Other
Enumeration date
04/23/2014
Last updated
07/05/2023
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