Provider Demographics
NPI:1720830052
Name:HOUSTON, JOE JR
Entity Type:Individual
Prefix:
First Name:JOE
Middle Name:
Last Name:HOUSTON
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1110 OAK DR SE UNIT 2
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20032-5951
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1110 OAK DR SE UNIT 2
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20032-5951
Practice Address - Country:US
Practice Address - Phone:202-907-9875
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-02
Last Update Date:2024-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
No101200000XBehavioral Health & Social Service ProvidersDrama Therapist
No225800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRecreation Therapist
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education
No172V00000XOther Service ProvidersCommunity Health Worker