Provider Demographics
NPI:1770166720
Name:LAMBERT, JENNA LOU (PT)
Entity type:Individual
Prefix:MS
First Name:JENNA
Middle Name:LOU
Last Name:LAMBERT
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:308 WHITTIER ST
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND VILLAGE
Mailing Address - State:TX
Mailing Address - Zip Code:75077-7019
Mailing Address - Country:US
Mailing Address - Phone:972-948-5082
Mailing Address - Fax:
Practice Address - Street 1:800 COLLEGE PKWY
Practice Address - Street 2:
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75077-3503
Practice Address - Country:US
Practice Address - Phone:972-420-8543
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-28
Last Update Date:2022-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10902802251G0304X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics