Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | J8942 | TX |
N | 208000000X | Pediatrician | MD423285 | PA |
N | 2080P0204X | Pediatric Emergency Doctor | MD423285 | PA |
NPI | 1043288988 |
---|---|
Provider Name | Patricia Fuyuki Campbell |
First Address | Houston, TX 77046-0297 |
Second Address | Houston, TX 77030-2608 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/03/2006 |
Last Update Date | 25/04/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
030779504 | (05) | TX |
030779505 | CSHCN (01) | TX |
1009362930001 | (05) | PA |
606695 | HIGHMARK BS (01) | PW |
8V3104 | BCBS (01) | TX |
G18158 | (02) |