Provider Demographics
NPI:1740315142
Name:HOUSTON, WILLIAM NEIL (OPTICIAN)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:NEIL
Last Name:HOUSTON
Suffix:
Gender:M
Credentials:OPTICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 W CHISHOLM ST
Mailing Address - Street 2:
Mailing Address - City:ALPENA
Mailing Address - State:MI
Mailing Address - Zip Code:49707-2418
Mailing Address - Country:US
Mailing Address - Phone:989-356-0688
Mailing Address - Fax:
Practice Address - Street 1:205 W CHISHOLM ST
Practice Address - Street 2:
Practice Address - City:ALPENA
Practice Address - State:MI
Practice Address - Zip Code:49707-2418
Practice Address - Country:US
Practice Address - Phone:989-356-0688
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician