Provider Demographics
NPI:1871867382
Name:DEWBRE, LAMONTE LEE
Entity Type:Individual
Prefix:
First Name:LAMONTE
Middle Name:LEE
Last Name:DEWBRE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:116 HIGHWAY 114 ESTS
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79407-8004
Mailing Address - Country:US
Mailing Address - Phone:806-598-2669
Mailing Address - Fax:
Practice Address - Street 1:4833 50TH ST
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79414-3418
Practice Address - Country:US
Practice Address - Phone:806-771-3560
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-01
Last Update Date:2012-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX632456363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily