Provider Demographics
NPI:1245002070
Name:LAMBDA MEDICAL, PLLC
Entity type:Organization
Organization Name:LAMBDA MEDICAL, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:STACEY
Authorized Official - Middle Name:DAWN
Authorized Official - Last Name:ERVIN
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:903-634-7004
Mailing Address - Street 1:3605 NE LOOP 286 STE 200
Mailing Address - Street 2:
Mailing Address - City:PARIS
Mailing Address - State:TX
Mailing Address - Zip Code:75460-5091
Mailing Address - Country:US
Mailing Address - Phone:903-634-7004
Mailing Address - Fax:903-213-9047
Practice Address - Street 1:3605 NE LOOP 286 STE 200
Practice Address - Street 2:
Practice Address - City:PARIS
Practice Address - State:TX
Practice Address - Zip Code:75460-5091
Practice Address - Country:US
Practice Address - Phone:903-634-7004
Practice Address - Fax:903-213-9047
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-25
Last Update Date:2024-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical SpecialtyGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty