Provider Demographics
NPI:1790227221
Name:LAUREN S CAMPBELL MD PA
Entity Type:Organization
Organization Name:LAUREN S CAMPBELL MD PA
Other - Org Name:CYPRESS DERMATOLOGY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT, PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:LAUREN
Authorized Official - Middle Name:SUZANNE
Authorized Official - Last Name:CAMPBELL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:832-455-9822
Mailing Address - Street 1:27700 NORTHWEST FREEWAY
Mailing Address - Street 2:SUITE 490
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77433-6766
Mailing Address - Country:US
Mailing Address - Phone:281-895-3376
Mailing Address - Fax:
Practice Address - Street 1:310 PAUL REVERE DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-6111
Practice Address - Country:US
Practice Address - Phone:713-505-5324
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-15
Last Update Date:2017-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN6207207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty