Provider Demographics
NPI:1235560186
Name:HOUSTON, ANTHONY II
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:
Last Name:HOUSTON
Suffix:II
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1904 N MOULTON CT
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73127-2720
Mailing Address - Country:US
Mailing Address - Phone:405-343-6994
Mailing Address - Fax:
Practice Address - Street 1:1904 N MOULTON CT
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73127-2720
Practice Address - Country:US
Practice Address - Phone:405-343-6994
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-03
Last Update Date:2013-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator