Provider Demographics
NPI:1467013961
Name:TAMBORELLO, ANTHONY JOSEPH JR (PHD)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:JOSEPH
Last Name:TAMBORELLO
Suffix:JR
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:17110 HOUSE HAHL RD STE C1
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77433-8576
Mailing Address - Country:US
Mailing Address - Phone:651-505-3273
Mailing Address - Fax:918-382-1285
Practice Address - Street 1:17110 HOUSE HAHL RD STE C1
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77433-8576
Practice Address - Country:US
Practice Address - Phone:651-505-3273
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-25
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX40088103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical