MEDICARE: CAMPBELL HEALTH CENTER LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2081P2900X	Pain Medicine (Physical Medicine & Rehabilitation) Physician

General Provider Information

NPI Number	:	1720656481
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CAMPBELL HEALTH CENTER LLC

Provider Business Mailing Address
First Line	:	12335 KINGSRIDE LN # 426
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77024-4116
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1012 CAMPBELL RD # 1
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77055-7408
Country	:	US
Telephone Number	:	832-371-9001
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. SUHYUN AN
Credential	:	DC NP
Telephone Number	:	832-875-7509

Provider Enumeration Date	:	06/17/2021
Last Update Date	:	06/17/2021

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Directions to “CAMPBELL HEALTH CENTER LLC ” Practice Location

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