MEDICARE: L CAMP 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	208600000X	Surgery Physician
2	261Q00000X	Clinic/Center

General Provider Information

NPI Number	:	1972002525
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	L CAMP LLC

Provider Business Mailing Address
First Line	:	1725 MAIN ST STE 2
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77002-8142
Country	:	US
Telephone Number	:	832-285-6052
Fax Number	:

Provider Business Practice Location Address
First Line	:	1725 MAIN ST STE 2
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77002-8142
Country	:	US
Telephone Number	:	832-285-6052
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	LASHONDRIA SIMPSON-CAMP
Credential	:	M.D.
Telephone Number	:	832-285-6052

Provider Enumeration Date	:	02/09/2018
Last Update Date	:	02/09/2018

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Directions to “L CAMP LLC ” Practice Location

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