Provider Demographics
NPI:1144208315
Name:HOUCK, MICHAEL WILLIAM (DO)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:WILLIAM
Last Name:HOUCK
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3206 4TH ST
Mailing Address - Street 2:
Mailing Address - City:LONGVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:75605-5143
Mailing Address - Country:US
Mailing Address - Phone:940-232-1261
Mailing Address - Fax:903-663-9960
Practice Address - Street 1:713 E ANDERSON ST
Practice Address - Street 2:
Practice Address - City:WEATHERFORD
Practice Address - State:TX
Practice Address - Zip Code:76086-5705
Practice Address - Country:US
Practice Address - Phone:409-232-1261
Practice Address - Fax:903-663-9960
Is Sole Proprietor?:No
Enumeration Date:2006-01-06
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ97122085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1365884-09Medicaid
TX1365884-09Medicaid
TX8L3208Medicare PIN
TX279481YK6GMedicare PIN
TX89400RMedicare ID - Type UnspecifiedMEDICARE
TX279481YK6LMedicare PIN
TX8L0878Medicare PIN
TX1365884-09Medicaid
TX136588413Medicaid
TX279481YK6NMedicare PIN