Individual
CAMILO PENA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
602 INDIANA AVE, LUBBOCK, TX 79415-3364
(806) 775-8200
(806) 472-6802
Mailing address
3601 4TH ST, MS 9410, LUBBOCK, TX 79430-0002
(806) 743-3150
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
R1273
TX
207RN0300X
Nephrology Physician
R1273
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/27/2013
Last updated
11/22/2021
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