Individual
DR. MARK T HOUSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
15945 CLAYTON RD, SUITE 330, BALLWIN, MO 63011-2490
(636) 256-5380
(636) 256-5396
Mailing address
15945 CLAYTON RD, SUITE 330, BALLWIN, MO 63011-2490
(636) 256-5380
(636) 256-5396
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
R2D71
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080134765
RAILROAD MEDICARE
MO
05
—
1689640344
—
MO
Enumeration date
02/23/2006
Last updated
07/23/2015
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