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Luis Hernando Camacho

Internal Medicine

Allopathic & Osteopathic Physicians

6560 Fannin Street, Suite 1224, Houston, TX 77030

PECOS Enrollment

This provider is enrolled in PECOS as LUIS CAMACHO.

Based on the most recent information from CMS, provider Luis Hernando Camacho is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records yesterday at 11:26 AM.

Profile Details

Provider ID
1336249960
Provider Type
Individual
Full Name
Camacho, Luis Hernando
Title
Dr.
Credential
M.D., MPH

Gender
Male
Sole Proprietor
Yes
Enumeration Date
9/24/2006
Last Updated
8/15/2014

Contact Information

Practice Location

6560 Fannin Street, Suite 1224, Houston, TX 77030

(713) 796-1200

(713) 795-0735

Mailing Location

6560 Fannin St, Suite 1224, Houston, TX 77030-2761

(713) 796-1200

(713) 795-0735

Provider Taxonomies

Code	Description	License
Code 207RH0003X Primary	Description Internal Medicine Allopathic & Osteopathic Physicians	License L2829 Texas

Provider Identifiers

ID	Description	Issuer
ID 148041001	Description Medicaid	Issuer Unlisted Texas
ID 8P0572	Description Other	Issuer HMO BLUE Texas
ID 01065744	Description Other	Issuer AMERIGROUP

Luis Hernando Camacho

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

ID

Description

Issuer

ID

Description

Issuer

Marconescu, Andrei

Blum Murphy, Mariela Anabel

Mccarthy, John J

Lara-Martinez, Hugo R

Ma, Hilary Yu-Heng

Ishizawa, Jo

Teegavarapu, Purnima Sravanti

Bouligny, Ian

Flowers, Christopher Robert

Hude, Kevin Robert