Individual
MISS CAMILLA BROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1504 TAUB LOOP, HOUSTON, TX 77030-1608
(713) 873-2000
Mailing address
2 GREENWAY PLZ, SUITE 900, HOUSTON, TX 77046-0297
(713) 798-1835
(713) 798-1144
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA04963
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
741648333
TAX ID
TX
Enumeration date
12/21/2006
Last updated
07/21/2009
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