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Individual

MR. DONALD CAMILLO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
C.R.N.A.

Contact information

Practice address
1854 LAKEPOINTE DR, LEWISVILLE, TX 75057-6442
(972) 315-1401
Mailing address
PO BOX 292394, LEWISVILLE, TX 75029-2394
(972) 668-7460

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
35211
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0071391-01
TX
01
DX62
BLUE CROSS / BLUE SHIELD
TX
Enumeration date
10/18/2006
Last updated
08/14/2008
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