Provider Demographics
NPI:1467717876
Name:HOUSTON, GARY ANTHONY
Entity Type:Individual
Prefix:
First Name:GARY
Middle Name:ANTHONY
Last Name:HOUSTON
Suffix:
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 1:1870 FOREST HILL BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33406-6061
Mailing Address - Country:US
Mailing Address - Phone:156-190-4651
Mailing Address - Fax:561-776-4213
Practice Address - Street 1:1870 FOREST HILL BLVD STE 200
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33406-6061
Practice Address - Country:US
Practice Address - Phone:156-190-4651
Practice Address - Fax:561-776-4213
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-11
Last Update Date:2012-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health