Provider Demographics
NPI:1588326953
Name:HOUGH, REGINIO T JR (DC)
Entity type:Individual
Prefix:
First Name:REGINIO
Middle Name:T
Last Name:HOUGH
Suffix:JR
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43835 SPRING ST
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93536-2517
Mailing Address - Country:US
Mailing Address - Phone:818-426-0965
Mailing Address - Fax:
Practice Address - Street 1:43835 SPRING ST
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93536-2517
Practice Address - Country:US
Practice Address - Phone:818-426-0965
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-12
Last Update Date:2021-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC23022111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor