Houston, Mark T

Houston, Mark T is an individual health care provider with primary practice located at 15945 Clayton Rd Suite 330, Ballwin MO 63011-2490. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Houston, Mark T can be contacted via phone (636) 256-5380.

Contact Information

Primary practice address
15945 Clayton Rd Suite 330 Ballwin MO 63011-2490
Phone: (636) 256-5380
Fax: (636) 256-5396
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X R2D71 Missouri

Profile Details

NPI number 1689640344
LBN Legal business name Houston, Mark T
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 23rd, 2006
Last updated Jul 23rd, 2015 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1689640344 NPPES
Missouri MEDICAID 1689640344
Missouri Other 080134765

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