Provider Demographics
NPI:1215535471
Name:CAMPOS, JOSE HIRAM JR (CCMA, CPT)
Entity type:Individual
Prefix:
First Name:JOSE
Middle Name:HIRAM
Last Name:CAMPOS
Suffix:JR
Gender:M
Credentials:CCMA, CPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9311 CLIFF POINT DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78250-3917
Mailing Address - Country:US
Mailing Address - Phone:210-412-5365
Mailing Address - Fax:
Practice Address - Street 1:9311 CLIFF POINT DR
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78250-3917
Practice Address - Country:US
Practice Address - Phone:210-412-5365
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-10
Last Update Date:2020-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ3M3Z9A9246RP1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy