Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | K1782 | TX |
Y | 111NI0900X | Internist | K1782 | TX |
NPI | 1003096033 |
---|---|
Provider Name | Robin Boliver-Campbell |
First Address | Houston, TX 77074-2001 |
Second Address | Houston, TX 77074-2001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/11/2007 |
Last Update Date | 30/07/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G49630 | (02) | TX |