Provider Demographics
NPI:1275565780
Name:OCAMPO, ELENA C (MD)
Entity Type:Individual
Prefix:DR
First Name:ELENA
Middle Name:C
Last Name:OCAMPO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6621 FANNIN ST
Mailing Address - Street 2:MC-19345
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-2358
Mailing Address - Country:US
Mailing Address - Phone:832-826-5600
Mailing Address - Fax:832-825-5630
Practice Address - Street 1:6621 FANNIN ST
Practice Address - Street 2:MC-19345
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2358
Practice Address - Country:US
Practice Address - Phone:832-382-6560
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2015-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL7829208000000X, 2080P0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric Cardiology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX157546601Medicaid
TX157546603Medicaid
TX157546602Medicaid
TX8F6682OtherBCBS
TX8K2551OtherBCBSTX
TXH81620Medicare UPIN
TX8D9580Medicare PIN
TX157546601Medicaid
TX8A5962Medicare PIN