Basic Information
| Provider Information | |||||||||
| NPI: | 1811463904 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CAMPBELL | ||||||||
| FirstName: | REBECCA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4806 SUNLIT WELL DR | ||||||||
| Address2: | |||||||||
| City: | SAN ANTONIO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 782475596 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2104956262 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1852 LOCKHILL SELMA RD STE 108 | ||||||||
| Address2: | |||||||||
| City: | SAN ANTONIO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 782131500 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2102717411 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/16/2018 | ||||||||
| LastUpdateDate: | 10/16/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WM0102X | 743194 | TX | N | 193400000X SINGLE SPECIALTY GROUP | Nursing Service Providers | Registered Nurse | Maternal Newborn | 207VM0101X | 743194 | TX | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Maternal & Fetal Medicine |
No ID Information.