Provider Demographics
NPI:1891777918
Name:HOULE, ALAN ROBERT (PA-C)
Entity Type:Individual
Prefix:MR
First Name:ALAN
Middle Name:ROBERT
Last Name:HOULE
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 BRAEMAR DR
Mailing Address - Street 2:
Mailing Address - City:CHESHIRE
Mailing Address - State:CT
Mailing Address - Zip Code:06410-1614
Mailing Address - Country:US
Mailing Address - Phone:203-272-2282
Mailing Address - Fax:203-574-5894
Practice Address - Street 1:1211 W MAIN ST
Practice Address - Street 2:
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06708-3106
Practice Address - Country:US
Practice Address - Phone:203-755-0163
Practice Address - Fax:203-574-5894
Is Sole Proprietor?:No
Enumeration Date:2005-11-15
Last Update Date:2013-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT000637OtherSTATE LICENSE
CT000637OtherSTATE LICENSE