Provider Demographics
NPI:1144321233
Name:HOUTS, BARBARA GAYLE (MD)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:GAYLE
Last Name:HOUTS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:BARBARA
Other - Middle Name:GAYLE
Other - Last Name:SWANSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2925 CHICAGO AVE
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55407-1321
Mailing Address - Country:US
Mailing Address - Phone:612-262-5000
Mailing Address - Fax:
Practice Address - Street 1:111 HUNDERTMARK RD
Practice Address - Street 2:TWO TWELVE MEDICAL CENTER, STE. 220
Practice Address - City:CHASKA
Practice Address - State:MN
Practice Address - Zip Code:55318-4551
Practice Address - Country:US
Practice Address - Phone:952-448-2050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2021-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN29355207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN80020918Medicare PIN