Provider Demographics
NPI:1841261484
Name:HOUCK, JAMES P (MD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:P
Last Name:HOUCK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:219 BRYANT ST.
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14222
Mailing Address - Country:US
Mailing Address - Phone:716-878-7701
Mailing Address - Fax:716-878-7316
Practice Address - Street 1:219 BRYANT ST.
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14222
Practice Address - Country:US
Practice Address - Phone:716-878-7701
Practice Address - Fax:716-878-7316
Is Sole Proprietor?:No
Enumeration Date:2006-01-31
Last Update Date:2013-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2029791207L00000X
NY202979207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01671486Medicaid
NY01671486Medicaid