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NPI Code Detail

MEDICARE: TIFFENY B CAMPBELL

MEDICARE: TIFFENY B CAMPBELL
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1171M00000XCase Manager/Care Coordinator

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1053921882
Entity Type Code : Individual
Provider Name (Legal Business Name) : TIFFENY B CAMPBELL
Provider Business Mailing Address
First Line : 519 N SAM HOUSTON PKWY E STE 175
Second Line :
City : HOUSTON
State : TX
Zip : 77060-4054
Country : US
Telephone Number : 832-943-4035
Fax Number :
Provider Business Practice Location Address
First Line : 519 N SAM HOUSTON PKWY E STE 175
Second Line :
City : HOUSTON
State : TX
Zip : 77060-4054
Country : US
Telephone Number : 832-943-4035
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/06/2020
Last Update Date : 08/06/2020

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Directions to “ TIFFENY B CAMPBELL ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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