Healthcare Provider Details

I. General information

NPI: 1245002070
Provider Name (Legal Business Name): LAMBDA MEDICAL, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/25/2023
Last Update Date: 02/17/2024
Certification Date: 12/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3605 NE LOOP 286 STE 200
PARIS TX
75460-5091
US

IV. Provider business mailing address

3605 NE LOOP 286 STE 200
PARIS TX
75460-5091
US

V. Phone/Fax

Practice location:
  • Phone: 903-634-7004
  • Fax: 903-213-9047
Mailing address:
  • Phone: 903-634-7004
  • Fax: 903-213-9047

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: STACEY DAWN ERVIN
Title or Position: NURSE PRACTITIONER
Credential: FNP
Phone: 903-634-7004