Healthcare Provider Details
I. General information
NPI: 1336141316
Provider Name (Legal Business Name): SHAWNA CECILIA LAMBERT-PITT M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: X
II. Dates (important events)
Enumeration Date: 08/10/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3560 DELAWARE ST
BEAUMONT TX
77706-3060
US
IV. Provider business mailing address
1256 MOORE RD
BEAUMONT TX
77713-3919
US
V. Phone/Fax
- Phone: 409-924-9666
- Fax:
- Phone: 409-753-1578
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207P00000X |
| Taxonomy | Emergency Medicine Physician |
| License Number | L9302 |
| License Number State | TX |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: