Provider Demographics
NPI:1235519125
Name:HOUSTON, HERBERT JR (CSA)
Entity Type:Individual
Prefix:MR
First Name:HERBERT
Middle Name:
Last Name:HOUSTON
Suffix:JR
Gender:M
Credentials:CSA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1510 32ND ST
Mailing Address - Street 2:
Mailing Address - City:GALVESTON
Mailing Address - State:TX
Mailing Address - Zip Code:77550-6824
Mailing Address - Country:US
Mailing Address - Phone:832-297-7085
Mailing Address - Fax:
Practice Address - Street 1:1510 32ND ST
Practice Address - Street 2:
Practice Address - City:GALVESTON
Practice Address - State:TX
Practice Address - Zip Code:77550-6824
Practice Address - Country:US
Practice Address - Phone:832-297-7085
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-04
Last Update Date:2015-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX3954246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant