Provider Demographics
NPI:1225252489
Name:LAMBERT, THOMAS JR (MD)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:
Last Name:LAMBERT
Suffix:JR
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 1:5791 COPELAND RD
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75703-3905
Mailing Address - Country:US
Mailing Address - Phone:903-509-2020
Mailing Address - Fax:
Practice Address - Street 1:5791 COPELAND RD
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75703-3905
Practice Address - Country:US
Practice Address - Phone:903-509-2020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-12
Last Update Date:2017-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN4537207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX45-2578435-004OtherTRICARE
TX8BL252OtherBLUE CROSS AND BLUE SHIELD
TX8GF751OtherBCBS
1225252489OtherRAILROAD MEDICARE
TX45-2578435-001OtherTRICARE
TX45-2578435-002OtherTRICARE
TX45-2578435-001OtherTRICARE