Provider Demographics
NPI:1427479922
Name:HOUSE, DARLENE
Entity type:Individual
Prefix:
First Name:DARLENE
Middle Name:
Last Name:HOUSE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12041 DESSAU RD
Mailing Address - Street 2:APT 1909
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78754-1700
Mailing Address - Country:US
Mailing Address - Phone:512-887-3900
Mailing Address - Fax:
Practice Address - Street 1:12041 DESSAU RD
Practice Address - Street 2:APT 1909
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78754-1700
Practice Address - Country:US
Practice Address - Phone:512-887-3900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-12-30
Last Update Date:2013-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA07727Y87171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor