Basic Information
| Provider Information | |||||||||
| NPI: | 1609967942 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HOUSTON | ||||||||
| FirstName: | WILLIAM | ||||||||
| MiddleName: | M. | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | JR. | ||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | P.O. BOX 191 | ||||||||
| Address2: | |||||||||
| City: | ROCKLAND | ||||||||
| State: | DE | ||||||||
| PostalCode: | 197230191 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3026514000 | ||||||||
| FaxNumber: | 3026514945 | ||||||||
| Practice Location | |||||||||
| Address1: | NEMOURS PEDIATRICS PHILADELPHIA PIKE | ||||||||
| Address2: | 222 PHILADELPHIA PIKE | ||||||||
| City: | WILMINGTON | ||||||||
| State: | DE | ||||||||
| PostalCode: | 198093166 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3027614660 | ||||||||
| FaxNumber: | 3027614666 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/28/2006 | ||||||||
| LastUpdateDate: | 09/15/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | C10003975 | DE | Y | Allopathic & Osteopathic Physicians | Pediatrics | 208D00000X | C10003975 | DE | N | Allopathic & Osteopathic Physicians | General Practice |
ID Information
| ID | Type | State | Issuer | Description | 1035646 | 05 | PA | MEDICAID | 5485509 | 05 | NJ | MEDICAID | 1991515 | 05 | MD | MEDICAID | 6701205 | 05 | VA | MEDICAID |