Provider Demographics
NPI:1962948679
Name:PRICE, CAMERON PAIGE (PA-C)
Entity type:Individual
Prefix:
First Name:CAMERON
Middle Name:PAIGE
Last Name:PRICE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:CAMERON
Other - Middle Name:PAIGE
Other - Last Name:GOBBELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:1301 W 38TH ST STE 601
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78705-1069
Mailing Address - Country:US
Mailing Address - Phone:512-454-5171
Mailing Address - Fax:512-454-0704
Practice Address - Street 1:1055 RIBAUT RD
Practice Address - Street 2:SUITE 30
Practice Address - City:BEAUFORT
Practice Address - State:SC
Practice Address - Zip Code:29902-5423
Practice Address - Country:US
Practice Address - Phone:843-524-8171
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-19
Last Update Date:2023-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA11369363A00000X
SC2685363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXPA11369OtherTEXAS MEDICAL LICENSE
TXPA11369OtherTEXAS MEDICAL LICENSE