Provider Demographics
NPI:1811979958
Name:HOUSER, ANGELA G (MD)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:G
Last Name:HOUSER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ANGELA
Other - Middle Name:G
Other - Last Name:CHRISTMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:37 MEDICAL CROSSING ROAD
Mailing Address - Street 2:
Mailing Address - City:TAMAQUA
Mailing Address - State:PA
Mailing Address - Zip Code:18252
Mailing Address - Country:US
Mailing Address - Phone:570-386-5926
Mailing Address - Fax:570-386-2959
Practice Address - Street 1:37 MEDICAL CROSSING ROAD
Practice Address - Street 2:
Practice Address - City:TAMAQUA
Practice Address - State:PA
Practice Address - Zip Code:18252
Practice Address - Country:US
Practice Address - Phone:570-386-5926
Practice Address - Fax:570-386-2959
Is Sole Proprietor?:No
Enumeration Date:2005-11-15
Last Update Date:2020-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD050532L207W00000X, 207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0015470090001Medicaid
PA15470090003Medicaid
PA15470090003Medicaid
PAG04672Medicare UPIN
G04672Medicare UPIN