Provider Demographics
NPI:1134698210
Name:CAMPOS, DANNY LOPEZ (APRN, MSN, FNP-C)
Entity Type:Individual
Prefix:MR
First Name:DANNY
Middle Name:LOPEZ
Last Name:CAMPOS
Suffix:
Gender:M
Credentials:APRN, MSN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1016 EDISON DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78201-3011
Mailing Address - Country:US
Mailing Address - Phone:210-859-4647
Mailing Address - Fax:
Practice Address - Street 1:26229 N CRANES MILL RD
Practice Address - Street 2:
Practice Address - City:CANYON LAKE
Practice Address - State:TX
Practice Address - Zip Code:78133-1957
Practice Address - Country:US
Practice Address - Phone:830-217-6411
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-18
Last Update Date:2018-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP138966207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty