Provider Demographics
NPI:1851616536
Name:HOUSER, MARCELLA REGINA (MD)
Entity Type:Individual
Prefix:MS
First Name:MARCELLA
Middle Name:REGINA
Last Name:HOUSER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:921 CHRISTANA PL
Mailing Address - Street 2:
Mailing Address - City:GRETNA
Mailing Address - State:LA
Mailing Address - Zip Code:70056-7621
Mailing Address - Country:US
Mailing Address - Phone:504-912-3260
Mailing Address - Fax:
Practice Address - Street 1:921 CHRISTANA PL
Practice Address - Street 2:
Practice Address - City:GRETNA
Practice Address - State:LA
Practice Address - Zip Code:70056-7621
Practice Address - Country:US
Practice Address - Phone:504-912-3260
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-06
Last Update Date:2014-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD.206340208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2106767Medicaid