Provider Demographics
NPI:1245204353
Name:HOUGEN, THOMAS JOEL (MD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:JOEL
Last Name:HOUGEN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:11920 CRAGWOOD WAY
Mailing Address - Street 2:
Mailing Address - City:POTOMAC
Mailing Address - State:MD
Mailing Address - Zip Code:20854-1201
Mailing Address - Country:US
Mailing Address - Phone:301-299-8391
Mailing Address - Fax:301-299-2795
Practice Address - Street 1:1625 N GEORGE MASON DR
Practice Address - Street 2:SUITE 405
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22205-3683
Practice Address - Country:US
Practice Address - Phone:703-717-4070
Practice Address - Fax:703-717-4071
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-15
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA01010455822080P0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
A54259Medicare UPIN