Provider Demographics
NPI:1437209210
Name:HOUSTON, JAMES MICHAEL SR (PA-C)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:MICHAEL
Last Name:HOUSTON
Suffix:SR
Gender:M
Credentials:PA-C
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Mailing Address - Street 1:1322 COUGAR RUN
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258-3451
Mailing Address - Country:US
Mailing Address - Phone:210-365-4170
Mailing Address - Fax:800-520-2747
Practice Address - Street 1:525 OAK CENTRE DR
Practice Address - Street 2:SUITE 100
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-3944
Practice Address - Country:US
Practice Address - Phone:210-695-2757
Practice Address - Fax:800-520-2747
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-12
Last Update Date:2010-12-13
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Provider Licenses
StateLicense IDTaxonomies
TXPA06783363AS0400X
NJ25MP00092000363AS0400X
NY8736363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical