Basic Information
Provider Information | |||||||||
NPI: | 1316327885 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | HOU | ||||||||
FirstName: | KEVIN | ||||||||
MiddleName: | YE | ||||||||
NamePrefix: |   | ||||||||
NameSuffix: |   | ||||||||
Credential: | M.D. | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | 2500 MARYLAND RD STE 400 | ||||||||
Address2: |   | ||||||||
City: | WILLOW GROVE | ||||||||
State: | PA | ||||||||
PostalCode: | 190901225 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 2154813915 | ||||||||
FaxNumber: | 2154816790 | ||||||||
Practice Location | |||||||||
Address1: | 3941 COMMERCE AVE | ||||||||
Address2: |   | ||||||||
City: | WILLOW GROVE | ||||||||
State: | PA | ||||||||
PostalCode: | 190901104 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 2154812400 | ||||||||
FaxNumber: | 2154817438 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 05/31/2015 | ||||||||
LastUpdateDate: | 08/09/2021 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | M | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: | 08/09/2021 |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | MT209050 | PA | N |   | Allopathic & Osteopathic Physicians | Internal Medicine |   | 207RH0003X | MD474751 | PA | Y |   | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology & Oncology |
No ID Information.