Provider Demographics
NPI:1205205838
Name:HOU, JASON
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:
Last Name:HOU
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:CAI
Other - Middle Name:D
Other - Last Name:HOU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:759 49TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11220-2206
Mailing Address - Country:US
Mailing Address - Phone:646-204-5223
Mailing Address - Fax:
Practice Address - Street 1:1926 VICTORY BLVD
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10314-3518
Practice Address - Country:US
Practice Address - Phone:718-354-5196
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-24
Last Update Date:2015-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005630-1171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist