Provider Demographics
NPI:1467449793
Name:HOUSER, BRIAN JAMES (OD)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:JAMES
Last Name:HOUSER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1995 CEDAR ST
Mailing Address - Street 2:STE. 1
Mailing Address - City:HOLT
Mailing Address - State:MI
Mailing Address - Zip Code:48842-6630
Mailing Address - Country:US
Mailing Address - Phone:517-699-3937
Mailing Address - Fax:517-699-4199
Practice Address - Street 1:1995 CEDAR ST
Practice Address - Street 2:STE. 1
Practice Address - City:HOLT
Practice Address - State:MI
Practice Address - Zip Code:48842-6630
Practice Address - Country:US
Practice Address - Phone:517-699-3937
Practice Address - Fax:517-699-4199
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4901004011152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIU-83107Medicare UPIN