Provider Demographics
NPI:1053356394
Name:CAMPBELL, ANDREW WILLIAM (MD)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:WILLIAM
Last Name:CAMPBELL
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:25010 OAKHURST DRIVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77386-1916
Mailing Address - Country:US
Mailing Address - Phone:281-681-8989
Mailing Address - Fax:281-681-8787
Practice Address - Street 1:25010 OAKHURST DR
Practice Address - Street 2:SUITE 200
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77386-2719
Practice Address - Country:US
Practice Address - Phone:281-681-8989
Practice Address - Fax:281-681-8787
Is Sole Proprietor?:No
Enumeration Date:2006-06-19
Last Update Date:2007-07-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXC. IMMUNOTOXICOLOGY173000000X, 174400000X
TXG77901744R1102X, 207Q00000X
TXNEUROTOXICOLOGY209800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No173000000XOther Service ProvidersLegal Medicine
No1744R1102XOther Service ProvidersSpecialistResearch Study
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No209800000XAllopathic & Osteopathic PhysiciansLegal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXG7790OtherTEXAS LIC. NUMBER