Provider Demographics
NPI:1629376074
Name:CAMILLE'S MEDICAL SERVICES INC
Entity Type:Organization
Organization Name:CAMILLE'S MEDICAL SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KATE
Authorized Official - Middle Name:EGONDO
Authorized Official - Last Name:KOKO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-277-0205
Mailing Address - Street 1:3836 GREENBRIAR DR
Mailing Address - Street 2:
Mailing Address - City:STAFFORD
Mailing Address - State:TX
Mailing Address - Zip Code:77477-3926
Mailing Address - Country:US
Mailing Address - Phone:281-277-0205
Mailing Address - Fax:281-277-0347
Practice Address - Street 1:8449 W BELLFORT ST
Practice Address - Street 2:230
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77071-2245
Practice Address - Country:US
Practice Address - Phone:713-988-0107
Practice Address - Fax:713-988-0100
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-09
Last Update Date:2014-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric MedicineGroup - Multi-Specialty