Provider Demographics
NPI:1174581870
Name:HOUGH, KEVIN ANDREW (DO)
Entity type:Individual
Prefix:
First Name:KEVIN
Middle Name:ANDREW
Last Name:HOUGH
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1700 COGDELL BLVD
Mailing Address - Street 2:
Mailing Address - City:SNYDER
Mailing Address - State:TX
Mailing Address - Zip Code:79549-6162
Mailing Address - Country:US
Mailing Address - Phone:325-573-1300
Mailing Address - Fax:325-574-6987
Practice Address - Street 1:1700 COGDELL BLVD
Practice Address - Street 2:
Practice Address - City:SNYDER
Practice Address - State:TX
Practice Address - Zip Code:79549
Practice Address - Country:US
Practice Address - Phone:325-573-1300
Practice Address - Fax:325-574-6987
Is Sole Proprietor?:No
Enumeration Date:2006-05-02
Last Update Date:2024-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOT016554207R00000X
UT5708467-1206363A00000X
TXR6209207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
S68688Medicare UPIN