Provider Demographics
NPI:1598720583
Name:HOUGEN, STEPHEN THORSHEIM (MD)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:THORSHEIM
Last Name:HOUGEN
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:PO BOX 674339
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75267-4339
Mailing Address - Country:US
Mailing Address - Phone:830-201-7100
Mailing Address - Fax:830-201-7304
Practice Address - Street 1:800 W HIGHWAY 71
Practice Address - Street 2:
Practice Address - City:MARBLE FALLS
Practice Address - State:TX
Practice Address - Zip Code:78654-8602
Practice Address - Country:US
Practice Address - Phone:830-201-7100
Practice Address - Fax:830-201-7304
Is Sole Proprietor?:No
Enumeration Date:2006-04-20
Last Update Date:2013-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF1660208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX131304103Medicaid
TX88620SOtherBLUE CROSS/SHIELD
TX8BV700OtherBLUECROSS BLUESHIELD OF TEXAS
TX8BV700OtherBLUECROSS BLUESHIELD OF TEXAS
TX88460KMedicare ID - Type Unspecified