Healthcare Provider Details

I. General information

NPI: 1821193152
Provider Name (Legal Business Name): PAUL CAMDEN BREEDING D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/13/2006
Last Update Date: 10/27/2020
Certification Date: 10/27/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2620 CULLEN PKWY STE 202
PEARLAND TX
77581-9008
US

IV. Provider business mailing address

2620 CULLEN PKWY STE 202
PEARLAND TX
77581-9008
US

V. Phone/Fax

Practice location:
  • Phone: 281-412-0900
  • Fax: 281-412-4020
Mailing address:
  • Phone: 281-412-0900
  • Fax: 281-412-4020

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number4323
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: