Provider Demographics
NPI:1063668176
Name:LAMBAT, MANISH PRABHAKAR (MD)
Entity Type:Individual
Prefix:DR
First Name:MANISH
Middle Name:PRABHAKAR
Last Name:LAMBAT
Suffix:
Gender:M
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 749
Mailing Address - Street 2:
Mailing Address - City:PHARR
Mailing Address - State:TX
Mailing Address - Zip Code:78577-1614
Mailing Address - Country:US
Mailing Address - Phone:956-362-8205
Mailing Address - Fax:956-362-8209
Practice Address - Street 1:2821 MICHAELANGELO DR STE 102
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-1411
Practice Address - Country:US
Practice Address - Phone:956-362-8205
Practice Address - Fax:956-362-8209
Is Sole Proprietor?:No
Enumeration Date:2008-08-09
Last Update Date:2020-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP73587207XS0117X
TXP1890207XP3100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XP3100XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryPediatric Orthopaedic Surgery
No207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX292376502Medicaid
TX292376503Medicaid