Healthcare Provider Details

I. General information

NPI: 1124182498
Provider Name (Legal Business Name): CARMON L LAMPLEY-ROBERTS OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MISS CARMON LEIGH LAMPLEY

II. Dates (important events)

Enumeration Date: 12/21/2006
Last Update Date: 10/27/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 MEDICAL CENTER BLVD
LUFKIN TX
75904-3173
US

IV. Provider business mailing address

2 MEDICAL CENTER BLVD
LUFKIN TX
75904-3173
US

V. Phone/Fax

Practice location:
  • Phone: 936-634-8434
  • Fax: 936-639-2581
Mailing address:
  • Phone: 936-634-8434
  • Fax: 936-639-2581

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number6284TG
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: