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General NPI Number Information
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NPI Number | 1972002525
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Entity Type | Organization
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Legal Business Name | L CAMP LLC
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Dates
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Enumeration Date | 02/09/2018
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Last Update Date | 02/09/2018
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Provider Practice Location Address
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Address Line | 1725 MAIN ST STE 2
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City | HOUSTON
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State | TX
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Zip | 77002-8142
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Country | US
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Telephone | 832-285-6052
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Fax |
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Provider Business Mailing Address
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Address Line | 1725 MAIN ST STE 2
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City | HOUSTON
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State | TX
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Zip | 77002-8142
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Country | US
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Telephone | 832-285-6052
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | LASHONDRIA SIMPSON-CAMP
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Credential | M.D.
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Telephone | 832-285-6052
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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