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General NPI Number Information
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NPI Number | 1174837058
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Entity Type | Organization
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Legal Business Name | DARRYL CAMP MD PA
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Dates
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Enumeration Date | 08/03/2010
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Last Update Date | 08/03/2010
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Provider Practice Location Address
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Address Line | 1201 W 38TH ST
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City | AUSTIN
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State | TX
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Zip | 78705-1006
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Country | US
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Telephone | 512-551-0846
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Fax |
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Provider Business Mailing Address
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Address Line | 5103 KYLE CENTER DR SUITE 104
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City | KYLE
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State | TX
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Zip | 78640-6163
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Country | US
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Telephone | 512-551-0846
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DARRYL S CAMP
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Credential | MD
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Telephone | 512-551-0846
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084V0102X
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Taxonomy Name | Vascular Neurology Physician
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License Number | K2317
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | K2317
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License Number State | TX
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