Provider Demographics
NPI:1124182498
Name:LAMPLEY-ROBERTS, CARMON L (OD)
Entity Type:Individual
Prefix:DR
First Name:CARMON
Middle Name:L
Last Name:LAMPLEY-ROBERTS
Suffix:
Gender:F
Credentials:OD
Other - Prefix:MISS
Other - First Name:CARMON
Other - Middle Name:LEIGH
Other - Last Name:LAMPLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2 MEDICAL CENTER BLVD
Mailing Address - Street 2:
Mailing Address - City:LUFKIN
Mailing Address - State:TX
Mailing Address - Zip Code:75904-3173
Mailing Address - Country:US
Mailing Address - Phone:936-634-8434
Mailing Address - Fax:936-639-2581
Practice Address - Street 1:2 MEDICAL CENTER BLVD
Practice Address - Street 2:
Practice Address - City:LUFKIN
Practice Address - State:TX
Practice Address - Zip Code:75904-3173
Practice Address - Country:US
Practice Address - Phone:936-634-8434
Practice Address - Fax:936-639-2581
Is Sole Proprietor?:No
Enumeration Date:2006-12-21
Last Update Date:2011-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6284TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX185830001Medicaid
TX8F4907Medicare PIN
TXV12339Medicare UPIN