Provider Demographics
NPI:1841845054
Name:LAMBINO, JAFFREY
Entity type:Individual
Prefix:
First Name:JAFFREY
Middle Name:
Last Name:LAMBINO
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 1:3103 SINGLE RIDGE WAY
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77493-4422
Mailing Address - Country:US
Mailing Address - Phone:281-781-9415
Mailing Address - Fax:
Practice Address - Street 1:1401 EAGLE LAKE ROAD
Practice Address - Street 2:
Practice Address - City:SEALLY
Practice Address - State:TX
Practice Address - Zip Code:77474
Practice Address - Country:US
Practice Address - Phone:979-885-2937
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-05
Last Update Date:2019-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2142161208100000X, 225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation