Provider Demographics
NPI:1447388285
Name:LAMARRA, ANTHONY J (DPM)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:J
Last Name:LAMARRA
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2621 S SHEPHERD DR
Mailing Address - Street 2:#220
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77098-1515
Mailing Address - Country:US
Mailing Address - Phone:713-942-7700
Mailing Address - Fax:713-529-6527
Practice Address - Street 1:2621 S SHEPHERD DR
Practice Address - Street 2:#220
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77098-1515
Practice Address - Country:US
Practice Address - Phone:713-942-7700
Practice Address - Fax:713-529-6527
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1140213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX31875Medicaid
TX00G96COtherBCBS OF TEXAS
TX31875Medicaid
8590K0Medicare ID - Type Unspecified