Provider Demographics
NPI:1033586789
Name:LAMPKIN, JANEA DAVISON (PA - C)
Entity Type:Individual
Prefix:MRS
First Name:JANEA
Middle Name:DAVISON
Last Name:LAMPKIN
Suffix:
Gender:F
Credentials:PA - C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:718 LEXINGTON AVE.,
Mailing Address - Street 2:SUITE 102
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78212
Mailing Address - Country:US
Mailing Address - Phone:726-208-3118
Mailing Address - Fax:210-899-1958
Practice Address - Street 1:718 LEXINGTON AVE.,
Practice Address - Street 2:SUITE 102
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78212
Practice Address - Country:US
Practice Address - Phone:210-420-8671
Practice Address - Fax:210-899-1958
Is Sole Proprietor?:No
Enumeration Date:2015-08-28
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA09988363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX354108801Medicaid
TX466680YMSZMedicare PIN