Provider Demographics
NPI:1679548440
Name:LAMBIASE, MATTHEW (DO)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:
Last Name:LAMBIASE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1416
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78295-1416
Mailing Address - Country:US
Mailing Address - Phone:830-890-5181
Mailing Address - Fax:830-890-5162
Practice Address - Street 1:712 HILL COUNTRY DR STE 100
Practice Address - Street 2:
Practice Address - City:KERRVILLE
Practice Address - State:TX
Practice Address - Zip Code:78028-6166
Practice Address - Country:US
Practice Address - Phone:830-890-5181
Practice Address - Fax:830-890-5162
Is Sole Proprietor?:No
Enumeration Date:2006-02-22
Last Update Date:2024-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN02002212A207N00000X
TXM2999207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology