Provider Demographics
NPI:1124914023
Name:CAMPOS, FELIPE JR
Entity type:Individual
Prefix:
First Name:FELIPE
Middle Name:
Last Name:CAMPOS
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1111 HAWKINS BLVD STE 2A
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79925-6400
Mailing Address - Country:US
Mailing Address - Phone:915-771-8346
Mailing Address - Fax:915-771-8347
Practice Address - Street 1:1111 HAWKINS BLVD STE 2A
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79925-6400
Practice Address - Country:US
Practice Address - Phone:915-771-8346
Practice Address - Fax:915-771-8347
Is Sole Proprietor?:No
Enumeration Date:2025-06-16
Last Update Date:2025-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1201348363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology