Provider Demographics
NPI:1548092711
Name:CHOATE, CAMI DAWN
Entity type:Individual
Prefix:
First Name:CAMI
Middle Name:DAWN
Last Name:CHOATE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4221 BENNER ROAD BLDG 2 STE 250
Mailing Address - Street 2:
Mailing Address - City:KYLE
Mailing Address - State:TX
Mailing Address - Zip Code:78640
Mailing Address - Country:US
Mailing Address - Phone:512-596-4883
Mailing Address - Fax:
Practice Address - Street 1:4221 BENNER ROAD BLDG 2 STE 250
Practice Address - Street 2:KYLE
Practice Address - City:TEXAS
Practice Address - State:TX
Practice Address - Zip Code:78640
Practice Address - Country:US
Practice Address - Phone:512-596-4883
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-16
Last Update Date:2024-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician