Provider Demographics
NPI:1346700747
Name:CAMPBELL INTEGRATIVE MEDICINE, PLLC
Entity Type:Organization
Organization Name:CAMPBELL INTEGRATIVE MEDICINE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SUHYUN
Authorized Official - Middle Name:
Authorized Official - Last Name:AN
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:713-468-3155
Mailing Address - Street 1:1012 CAMPBELL RD # B
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77055-7408
Mailing Address - Country:US
Mailing Address - Phone:713-468-3155
Mailing Address - Fax:281-809-9881
Practice Address - Street 1:1012 CAMPBELL RD # B
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77055-7408
Practice Address - Country:US
Practice Address - Phone:713-468-3155
Practice Address - Fax:281-809-9881
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-21
Last Update Date:2019-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty