Individual
MRS. CAMILLE MARIE SMALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
400 W LBJ FWY STE 330, IRVING, TX 75063-3717
(972) 556-2885
(972) 506-8733
Mailing address
400 W LBJ FWY STE 330, IRVING, TX 75063-3717
(972) 556-2885
(972) 506-8733
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA11750
TX
Other
Enumeration date
02/09/2018
Last updated
02/09/2018
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