Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | P1169 | TX |
Y | 208600000X | Surgeon | P1169 | TX |
N | 2082S0105X | Plastic Hand Surgeon | P1169 | TX |
N | 208200000X | Surgeon | 121464 | NC |
N | 208600000X | Surgeon | 121464 | NC |
NPI | 1235267519 |
---|---|
Provider Name | Dr. Steven M Camp |
First Address | Fort Worth, TX 76107-5745 |
Second Address | Fort Worth, TX 76107 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/03/2007 |
Last Update Date | 06/10/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2972580-01 | (05) | TX |