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Individual

DR. NICHOLAS V. CAMPERLENGO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
616 W RUSSELL PL, SAN ANTONIO, TX 78212-3658
(800) 257-8715
(800) 819-1655
Mailing address
2601 BROOKRIDGE DR, HURST, TX 76054-2761
(817) 932-0102

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
K5265
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
117211601
TX
05
117211602
TX
05
117211603
TX
01
89412G
BLUE CROSS BLUE SHIELD
TX
Enumeration date
01/30/2007
Last updated
07/09/2007
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