Provider Demographics
NPI:1427877315
Name:HOUSTON, ELIZA A
Entity type:Individual
Prefix:
First Name:ELIZA
Middle Name:A
Last Name:HOUSTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ELIZA
Other - Middle Name:A
Other - Last Name:LEGGIONS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4210 LOCHINVER CIR
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48911-2575
Mailing Address - Country:US
Mailing Address - Phone:517-455-2446
Mailing Address - Fax:
Practice Address - Street 1:308 W LAPEER ST UNIT 1
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48933-1173
Practice Address - Country:US
Practice Address - Phone:517-214-2747
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-08
Last Update Date:2024-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider