Individual provider · Type 1 NPI

Cameron Trace Landreth, PA-C

Medical Physician Assistant · San Antonio, TX

NPI number 1659866119 Active

Practice location

12000 Huebner Rd Ste 104
San Antonio, TX 78230-1209

Call (210) 561-2422 Map

Fax (210) 561-2466

Mailing address

12000 Huebner Rd Ste 204
San Antonio, TX 78230-1213

Specialties and licenses

TaxonomyCodeLicense
Family Medicine Physician 207Q00000XPA12024 (TX)
Medical Physician Assistant Primary 363AM0700XPA12024 (TX)

Medical Physician Assistant: Definition to come...

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About NPI 1659866119

Cameron Trace Landreth, PA-C's National Provider Identifier is 1659866119, issued on Jun 27, 2018. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in San Antonio, TX. The record was last updated on Apr 4, 2019.