Basic Information
| Provider Information | |||||||||
| NPI: | 1609357714 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HOUSTON | ||||||||
| FirstName: | JOHN | ||||||||
| MiddleName: | PLEAS | ||||||||
| NamePrefix: | MR. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8301 N COUCIL RD | ||||||||
| Address2: | APT 406 | ||||||||
| City: | OKLAHOMA CITY | ||||||||
| State: | OK | ||||||||
| PostalCode: | 73123 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5807689331 | ||||||||
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| Practice Location | |||||||||
| Address1: | 804 W CHOCTAW AVE | ||||||||
| Address2: | |||||||||
| City: | CHICKASHA | ||||||||
| State: | OK | ||||||||
| PostalCode: | 730182310 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4052220622 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/27/2018 | ||||||||
| LastUpdateDate: | 08/27/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | OK | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.