Provider Demographics
NPI:1265462618
Name:CAMPBELL, ROBERT B (DO)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:B
Last Name:CAMPBELL
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2418 LONDONDERRY
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77581
Mailing Address - Country:US
Mailing Address - Phone:281-250-7445
Mailing Address - Fax:888-236-0374
Practice Address - Street 1:2418 LONDONDERRY DR
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77581-5159
Practice Address - Country:US
Practice Address - Phone:281-250-7445
Practice Address - Fax:888-236-0374
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2013-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH6089207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8G9226OtherBCBS
TX139269819Medicaid
TX139269819Medicaid
TX8G9226OtherBCBS
TXP0036498Medicare PIN