Provider Demographics
NPI:1013924257
Name:KAMPHAUS, JOHN NICHALOS (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:NICHALOS
Last Name:KAMPHAUS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1700 ALMA DR
Mailing Address - Street 2:SUITE 480
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75075-6937
Mailing Address - Country:US
Mailing Address - Phone:972-422-2008
Mailing Address - Fax:972-422-4014
Practice Address - Street 1:1700 ALMA DR
Practice Address - Street 2:SUITE 480
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75075-6937
Practice Address - Country:US
Practice Address - Phone:972-422-2008
Practice Address - Fax:972-422-4014
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2008-09-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXH17172084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXE08954Medicare UPIN