Provider Demographics
NPI:1700470531
Name:HOUSTON, PATRICK (CFO)
Entity Type:Individual
Prefix:
First Name:PATRICK
Middle Name:
Last Name:HOUSTON
Suffix:
Gender:M
Credentials:CFO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2693 FOREST HILLS RD SW STE E
Mailing Address - Street 2:
Mailing Address - City:WILSON
Mailing Address - State:NC
Mailing Address - Zip Code:27893-8611
Mailing Address - Country:US
Mailing Address - Phone:252-991-6109
Mailing Address - Fax:252-991-6110
Practice Address - Street 1:2693 FOREST HILLS RD SW STE E
Practice Address - Street 2:
Practice Address - City:WILSON
Practice Address - State:NC
Practice Address - Zip Code:27893-8611
Practice Address - Country:US
Practice Address - Phone:252-991-6109
Practice Address - Fax:252-991-6110
Is Sole Proprietor?:No
Enumeration Date:2021-02-23
Last Update Date:2021-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCCFO05241225000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225000000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotic Fitter