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NPI 1275515017

NPI 1275515017 : STUART MURRAY CAMPBELL MPT : FT. SAM HOUSTON, TX

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General NPI Number Information
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    NPI Number           |    1275515017
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    Entity Type          |    Individual 
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    Provider Name        |    STUART MURRAY CAMPBELL MPT
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    11/17/2005
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    3851 RODGER BROOKE DRIVE 
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    City                 |    FT. SAM HOUSTON
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    State                |    TX
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    Zip                  |    78234
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    Country              |    US
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    Telephone            |    210-916-2460
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    8018 CORAL TRL 
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    City                 |    SAN ANTONIO
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    State                |    TX
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    Zip                  |    78244-1879
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    Country              |    US
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    Telephone            |    
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    225100000X
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    Taxonomy Name        |    Physical Therapist
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    License Number       |    016534-1
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    License Number State |    NY
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