Provider Demographics
NPI:1013099621
Name:HOUGHTON, JOSEPH SCOTT (CRNA)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:SCOTT
Last Name:HOUGHTON
Suffix:
Gender:M
Credentials:CRNA
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 841656
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-1656
Mailing Address - Country:US
Mailing Address - Phone:903-531-5000
Mailing Address - Fax:
Practice Address - Street 1:3140 LEGACY DR STE 310
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-9383
Practice Address - Country:US
Practice Address - Phone:903-531-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-20
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX582914367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX183208103Medicaid
TXP01291365OtherRAIL ROAD
TX75-0818167-015OtherTRICARE
TXP00294580OtherPART B RAILROAD MEDICARE
TX8895UEOtherBCBS BLUE
TX86316UOtherBCBS OF TEXAS
TX183208103Medicaid
TX86316UOtherBCBS OF TEXAS