Provider Demographics
NPI:1831114297
Name:HOUSTON, MICHAEL JOSEPH (DC)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:JOSEPH
Last Name:HOUSTON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1140 CHASE AVE
Mailing Address - Street 2:
Mailing Address - City:CORCORAN
Mailing Address - State:CA
Mailing Address - Zip Code:93212-2602
Mailing Address - Country:US
Mailing Address - Phone:559-904-0971
Mailing Address - Fax:
Practice Address - Street 1:220 S MOONEY BLVD
Practice Address - Street 2:SUITE D
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93291-4550
Practice Address - Country:US
Practice Address - Phone:559-734-7680
Practice Address - Fax:559-732-8510
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-13
Last Update Date:2009-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC27335111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor