Provider Demographics
NPI:1356088058
Name:MCAFEE, CAMEO
Entity Type:Individual
Prefix:
First Name:CAMEO
Middle Name:
Last Name:MCAFEE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5127 COSBY ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77021-3618
Mailing Address - Country:US
Mailing Address - Phone:832-849-6219
Mailing Address - Fax:
Practice Address - Street 1:5127 COSBY ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77021-3618
Practice Address - Country:US
Practice Address - Phone:832-849-6219
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-16
Last Update Date:2022-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX462224688Medicaid