Organization
PEACHTREE RADIOLOGY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL W HOUCK D.O. (PRESIDENT)
(940) 232-1261
Entity
Organization
Contact information
Practice address
713 E ANDERSON ST, WEATHERFORD, TX 76086-5705
(940) 232-1261
(903) 663-9960
Mailing address
3206 4TH ST, LONGVIEW, TX 75605-5143
(940) 232-1261
(903) 663-9960
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0066TJ
BLUE CROSS AND BLUE SHIELD
TX
05
—
PENDING
—
TX
Enumeration date
03/08/2010
Last updated
03/11/2024
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