Provider Demographics
NPI:1598737819
Name:HOUCHIN, AUBRA A (DO)
Entity type:Individual
Prefix:
First Name:AUBRA
Middle Name:A
Last Name:HOUCHIN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:4 BRANTLEIGH CT
Mailing Address - Street 2:
Mailing Address - City:SAINT CHARLES
Mailing Address - State:MO
Mailing Address - Zip Code:63301-4117
Mailing Address - Country:US
Mailing Address - Phone:636-947-4892
Mailing Address - Fax:
Practice Address - Street 1:408 JUNGERMANN RD
Practice Address - Street 2:
Practice Address - City:ST PETERS
Practice Address - State:MO
Practice Address - Zip Code:63376-2799
Practice Address - Country:US
Practice Address - Phone:636-449-5757
Practice Address - Fax:636-449-5750
Is Sole Proprietor?:No
Enumeration Date:2006-02-02
Last Update Date:2008-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR5C54207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO40514OtherHEALTHCARE USA
MO0100268OtherMEDICARE COMPLETE
MO9458OtherBLUECROSS BLUESHIELD
MOPC10213OtherCIGNA
MO104866OtherHEALTHLINK
MO4078508OtherAETNA
MOA10766OtherMERCY HEALTH PLANS
MO242530400Medicaid
MO431482544OtherUNITED HEALTHCARE
MO100513OtherBLUECROSS BLUESHIELD MO
MO32396OtherGROUP HEALTH PLAN (GHP)
MOA10766OtherMERCY HEALTH PLANS
MO104866OtherHEALTHLINK