Provider Demographics
NPI:1639172083
Name:SCOTT LAMB, M.D., P.A.
Entity type:Organization
Organization Name:SCOTT LAMB, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JEANNETTE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:LAMB
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:361-980-9312
Mailing Address - Street 1:5656 S STAPLES ST
Mailing Address - Street 2:STE 252
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78411-4655
Mailing Address - Country:US
Mailing Address - Phone:361-980-9312
Mailing Address - Fax:361-980-9158
Practice Address - Street 1:5656 S STAPLES ST
Practice Address - Street 2:STE 252
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78411-4655
Practice Address - Country:US
Practice Address - Phone:361-980-9312
Practice Address - Fax:361-980-9158
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-05-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK0885208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0022HGOtherBLUE CROSS BLUE SHIELD
00779WMedicare ID - Type Unspecified