Provider Demographics
NPI:1760038889
Name:LBN HARRISON CAMPBELL DC LLC
Entity Type:Organization
Organization Name:LBN HARRISON CAMPBELL DC LLC
Other - Org Name:RESTORATION HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DOCTOR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HARRISON
Authorized Official - Middle Name:KYLE
Authorized Official - Last Name:CAMPBELL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:281-344-0344
Mailing Address - Street 1:2121 WILLIAMS TRACE BLVD STE 300
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-4526
Mailing Address - Country:US
Mailing Address - Phone:281-344-2034
Mailing Address - Fax:281-783-2002
Practice Address - Street 1:2121 WILLIAMS TRACE BLVD STE 300
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-4526
Practice Address - Country:US
Practice Address - Phone:281-344-2034
Practice Address - Fax:281-783-2002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-14
Last Update Date:2021-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX13294OtherLICENSE