Provider Demographics
NPI:1093867822
Name:HOUGH, CASIE A (MOT, OTR)
Entity Type:Individual
Prefix:MRS
First Name:CASIE
Middle Name:A
Last Name:HOUGH
Suffix:
Gender:F
Credentials:MOT, OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:99 REGENCY PKWY
Mailing Address - Street 2:STE 313
Mailing Address - City:MANSFIELD
Mailing Address - State:TX
Mailing Address - Zip Code:76063-7817
Mailing Address - Country:US
Mailing Address - Phone:682-518-5100
Mailing Address - Fax:817-887-0815
Practice Address - Street 1:99 REGENCY PKWY
Practice Address - Street 2:STE 313
Practice Address - City:MANSFIELD
Practice Address - State:TX
Practice Address - Zip Code:76063-7817
Practice Address - Country:US
Practice Address - Phone:682-518-5100
Practice Address - Fax:817-887-0815
Is Sole Proprietor?:No
Enumeration Date:2007-01-18
Last Update Date:2016-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX109100225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX181041801Medicaid