Provider Demographics
NPI:1730472978
Name:TAMBORELLO, LYNSEY PROCTOR (MD)
Entity Type:Individual
Prefix:DR
First Name:LYNSEY
Middle Name:PROCTOR
Last Name:TAMBORELLO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:LYNSEY
Other - Middle Name:JERI
Other - Last Name:PROCTOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6550 FANNIN ST STE 2509
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-2777
Mailing Address - Country:US
Mailing Address - Phone:346-238-2040
Mailing Address - Fax:
Practice Address - Street 1:6550 FANNIN ST STE 2509
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2777
Practice Address - Country:US
Practice Address - Phone:346-238-2040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-20
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR44822084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry