Provider Demographics
NPI:1033156757
Name:CHAMBERS, LAJUAN JONES (MD)
Entity Type:Individual
Prefix:
First Name:LAJUAN
Middle Name:JONES
Last Name:CHAMBERS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1838
Mailing Address - Street 2:
Mailing Address - City:LAKE DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75065-1838
Mailing Address - Country:US
Mailing Address - Phone:572-823-5969
Mailing Address - Fax:
Practice Address - Street 1:6587 VIRGINIA PARKWAY
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75071
Practice Address - Country:US
Practice Address - Phone:972-548-8382
Practice Address - Fax:972-547-9951
Is Sole Proprietor?:No
Enumeration Date:2006-06-01
Last Update Date:2010-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2005019899208000000X, 2080P0207X
TXM8582208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2080P0207XAllopathic & Osteopathic PhysiciansPediatricsPediatric Hematology-Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX195552803Medicaid
TX195552804Medicaid
MO207407305Medicaid
MO714644OtherHEALTHLINK
MO199409OtherBLUE CHOICE
TX8BQ024OtherBCBS
MO199409OtherBLUE SHIELD
MOI40002Medicare UPIN
MO207407305Medicaid
MO934775236Medicare PIN