Healthcare Provider Details

I. General information

NPI: 1831620400
Provider Name (Legal Business Name): STEPHANIE N. CAMPBELL DPM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2017
Last Update Date: 11/14/2024
Certification Date: 11/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9901 CALIFORNIA RD
BROWNSVILLE TX
78521-6135
US

IV. Provider business mailing address

PO BOX 531968
HARLINGEN TX
78553-1968
US

V. Phone/Fax

Practice location:
  • Phone: 956-296-1681
  • Fax: 956-296-1680
Mailing address:
  • Phone: 833-887-4863
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number3180
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number3180
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: