Individual
DR. TIMOTHY C HOUGLAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2011018572
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12273374
CAQH
—
01
—
2011018572
LICENSE
MO
Enumeration date
06/03/2011
Last updated
08/23/2022
Update your record
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