Provider Demographics
NPI:1811096324
Name:WATSON, CAMILLE ANETTE (CNS, BC-PMH)
Entity type:Individual
Prefix:MS
First Name:CAMILLE
Middle Name:ANETTE
Last Name:WATSON
Suffix:
Gender:F
Credentials:CNS, BC-PMH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4101 PARKSTONE HEIGHTS DR STE 360
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78746-7482
Mailing Address - Country:US
Mailing Address - Phone:512-637-9090
Mailing Address - Fax:512-340-0096
Practice Address - Street 1:4101 PARKSTONE HEIGHTS DR STE 360
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78746-7482
Practice Address - Country:US
Practice Address - Phone:512-637-9090
Practice Address - Fax:512-340-0096
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2023-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP109017364SP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX158498903Medicaid
TXNP7155OtherBCBS PROVIDER #
TXNP7155OtherBCBS PROVIDER #
TXP002727Medicare UPIN