Provider Demographics
NPI:1003086596
Name:MICHELLE EVA LAMB
Entity Type:Organization
Organization Name:MICHELLE EVA LAMB
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:GRIFFITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-930-0020
Mailing Address - Street 1:310 W SAN AUGUSTINE ST
Mailing Address - Street 2:
Mailing Address - City:DEER PARK
Mailing Address - State:TX
Mailing Address - Zip Code:77536-4028
Mailing Address - Country:US
Mailing Address - Phone:281-930-0020
Mailing Address - Fax:281-930-8484
Practice Address - Street 1:310 W SAN AUGUSTINE ST
Practice Address - Street 2:
Practice Address - City:DEER PARK
Practice Address - State:TX
Practice Address - Zip Code:77536-4028
Practice Address - Country:US
Practice Address - Phone:281-930-0020
Practice Address - Fax:281-930-8484
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-11
Last Update Date:2015-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1028960001Medicare NSC