Provider Demographics
NPI:1508546714
Name:HOUGEN, ZACH JOEL
Entity Type:Individual
Prefix:
First Name:ZACH
Middle Name:JOEL
Last Name:HOUGEN
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 1:1007 MOSS DOWNS DR
Mailing Address - Street 2:
Mailing Address - City:GRANITE SHOALS
Mailing Address - State:TX
Mailing Address - Zip Code:78654-2724
Mailing Address - Country:US
Mailing Address - Phone:361-652-3689
Mailing Address - Fax:
Practice Address - Street 1:453 N BUSINESS IH 35 APT 420
Practice Address - Street 2:
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78130-7884
Practice Address - Country:US
Practice Address - Phone:361-652-3689
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-21
Last Update Date:2023-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2150229225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant