Provider Demographics
NPI:1861235384
Name:HOUSTON, MAHREE (DC)
Entity type:Individual
Prefix:DR
First Name:MAHREE
Middle Name:
Last Name:HOUSTON
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3351
Mailing Address - Street 2:
Mailing Address - City:HARVEY
Mailing Address - State:LA
Mailing Address - Zip Code:70059-3351
Mailing Address - Country:US
Mailing Address - Phone:504-452-6149
Mailing Address - Fax:
Practice Address - Street 1:3755 CARMIA DR SW STE 440
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30331-6253
Practice Address - Country:US
Practice Address - Phone:404-913-0926
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-13
Last Update Date:2024-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR011187111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor