Provider Demographics
NPI:1639294119
Name:LAMPE, CHARLES VICTOR (MD)
Entity Type:Individual
Prefix:
First Name:CHARLES
Middle Name:VICTOR
Last Name:LAMPE
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 1:8440 WALNUT HILL LN STE 610
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-3815
Mailing Address - Country:US
Mailing Address - Phone:214-345-6000
Mailing Address - Fax:214-345-6026
Practice Address - Street 1:8440 WALNUT HILL LN STE 610
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-3815
Practice Address - Country:US
Practice Address - Phone:214-345-6000
Practice Address - Fax:214-345-6026
Is Sole Proprietor?:No
Enumeration Date:2007-03-21
Last Update Date:2015-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL4512207RC0000X, 207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8G2432OtherBCBS
TX1535049-01Medicaid
TXH60674Medicare UPIN
TX8202B7Medicare PIN
TX405507YKQLMedicare PIN
TX405507YKP5Medicare PIN