Provider Demographics
NPI:1013951300
Name:HOUSTON, AVRIL M (MD)
Entity type:Individual
Prefix:
First Name:AVRIL
Middle Name:M
Last Name:HOUSTON
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 1:5600 FISHERS LANE
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20857
Mailing Address - Country:US
Mailing Address - Phone:301-443-0842
Mailing Address - Fax:
Practice Address - Street 1:5600 FISHERS LANE
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20857
Practice Address - Country:US
Practice Address - Phone:301-443-0842
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2012-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD632882080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD434207101Medicaid
H62833Medicare UPIN
MDN937Medicare PIN