Provider Demographics
NPI:1790959484
Name:HOUSE, DAVID THOMAS (NP)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:THOMAS
Last Name:HOUSE
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5754 STILLBROOKE DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77096-5930
Mailing Address - Country:US
Mailing Address - Phone:713-729-1090
Mailing Address - Fax:
Practice Address - Street 1:17500 W GRAND PKWY S
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-2562
Practice Address - Country:US
Practice Address - Phone:281-725-5000
Practice Address - Fax:281-725-5611
Is Sole Proprietor?:No
Enumeration Date:2008-04-15
Last Update Date:2015-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX660284363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX660284OtherLICENSE