Provider Demographics
NPI:1720466782
Name:CARON A HOUSTON, MD, INC
Entity type:Organization
Organization Name:CARON A HOUSTON, MD, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:CARON
Authorized Official - Middle Name:ALEXANDRA
Authorized Official - Last Name:HOUSTON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:916-245-6464
Mailing Address - Street 1:4005 MANZANITA AVE
Mailing Address - Street 2:6-234
Mailing Address - City:CARMICHAEL
Mailing Address - State:CA
Mailing Address - Zip Code:95608-1770
Mailing Address - Country:US
Mailing Address - Phone:916-245-6464
Mailing Address - Fax:
Practice Address - Street 1:4005 MANZANITA AVE
Practice Address - Street 2:6-234
Practice Address - City:CARMICHAEL
Practice Address - State:CA
Practice Address - Zip Code:95608-1770
Practice Address - Country:US
Practice Address - Phone:916-245-6464
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-11
Last Update Date:2015-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty