Provider Demographics
NPI:1912909847
Name:CAMPBELL, JOSLYN L (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSLYN
Middle Name:L
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2621 ALBANY ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77006-1501
Mailing Address - Country:US
Mailing Address - Phone:713-527-9427
Mailing Address - Fax:
Practice Address - Street 1:1415 LA CONCHA LN
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-1801
Practice Address - Country:US
Practice Address - Phone:713-790-9080
Practice Address - Fax:713-790-1664
Is Sole Proprietor?:No
Enumeration Date:2005-08-11
Last Update Date:2007-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL0064207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX143154601Medicaid
TX390007906OtherMEDICARE RAILROAD
TX8637K7OtherBLUE CROSS BLUE SHIELD
TX8637K7Medicare PIN
TX8637K7OtherBLUE CROSS BLUE SHIELD