Provider Demographics
NPI:1376637124
Name:HOUSTON, PATRICK (MD)
Entity Type:Individual
Prefix:
First Name:PATRICK
Middle Name:
Last Name:HOUSTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 FEDERAL ST # 200
Mailing Address - Street 2:
Mailing Address - City:CAMDEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08103-1088
Mailing Address - Country:US
Mailing Address - Phone:856-356-4924
Mailing Address - Fax:
Practice Address - Street 1:3 COOPER PLZ
Practice Address - Street 2:SUITE 411
Practice Address - City:CAMDEN
Practice Address - State:NJ
Practice Address - Zip Code:08103-1438
Practice Address - Country:US
Practice Address - Phone:856-342-3275
Practice Address - Fax:856-968-8468
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2021-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA27374207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ010004041OtherAMERICHOICE
NJ0391363006OtherCIGNA
NJ0081427000OtherAMERIHEALTH/KEYSTONE/IBC
NJ60018006OtherHORIZON NJ HEALTH
NJ390689OtherUNITED HEALTHCARE
NJ2905108Medicaid
NJ29335OtherUNIVERSITY HEALTH PLAN
NJ3K6086OtherHEALTHNET
NJP408277OtherOXFORD
NJ122670OtherAMERIHEALTH PPO/PABS
NJ1071240OtherAETNA
NJ1071240OtherAETNA
NJ390689OtherUNITED HEALTHCARE