Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111NX0800X | Chiropractor Orthopedic Specialist | DC5099 | TX |
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 765935 | TX |
NPI | 1073561494 |
---|---|
Provider Name | Timothy Chris Lambert |
First Address | Tyler, TX 75711-6605 |
Second Address | Tyler, TX 75701-5413 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/05/2006 |
Last Update Date | 07/02/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
T84775 | (02) | TX |