Provider Demographics
NPI:1902614431
Name:HOUSTON, MAKENNA CATHERINE
Entity type:Individual
Prefix:
First Name:MAKENNA
Middle Name:CATHERINE
Last Name:HOUSTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1150 N 18TH ST STE 401
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79601-2931
Mailing Address - Country:US
Mailing Address - Phone:325-670-4560
Mailing Address - Fax:833-437-1256
Practice Address - Street 1:1150 N 18TH ST STE 401
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79601-2931
Practice Address - Country:US
Practice Address - Phone:325-670-4560
Practice Address - Fax:833-437-1256
Is Sole Proprietor?:No
Enumeration Date:2024-12-30
Last Update Date:2024-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant