Provider Demographics
NPI:1912505389
Name:LUMPFORD, ROBERT STEVENS
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:STEVENS
Last Name:LUMPFORD
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 1:1209 NORTHWEST HWY # 160
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75041-5835
Mailing Address - Country:US
Mailing Address - Phone:214-478-4198
Mailing Address - Fax:
Practice Address - Street 1:2813 SEMINARY CIR
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75043-1210
Practice Address - Country:US
Practice Address - Phone:214-578-2639
Practice Address - Fax:469-249-3517
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-16
Last Update Date:2022-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX021263253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care