Provider Demographics
NPI:1750029302
Name:CAMPOS, ERIK ANTHONY (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:ERIK
Middle Name:ANTHONY
Last Name:CAMPOS
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5326 ROAN BRK
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78251-4383
Mailing Address - Country:US
Mailing Address - Phone:210-508-3981
Mailing Address - Fax:
Practice Address - Street 1:7555 NW LOOP 410 STE 114
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78245-2354
Practice Address - Country:US
Practice Address - Phone:210-520-8070
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-24
Last Update Date:2022-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX3128797225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist