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General NPI Number Information
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NPI Number | 1982691010
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Entity Type | Individual
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Provider Name | MATTHEW EDWARD LAMBERT PH.D.
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Gender | Male
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Dates
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Enumeration Date | 10/04/2005
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Last Update Date | 07/30/2020
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Provider Practice Location Address
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Address Line | 1315 WATERS EDGE DR. #112B
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City | GRANBURY
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State | TX
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Zip | 76048-1300
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Country | US
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Telephone | 817-876-6056
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Fax | 817-607-8203
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Provider Business Mailing Address
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Address Line | 1315 WATERS EDGE DR. #112B
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City | GRANBURY
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State | TX
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Zip | 76048-1300
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Country | US
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Telephone | 817-876-6056
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Fax | 817-607-8203
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number | PSY-202896
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License Number State | ID
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Taxonomy #2
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number | PSY-202896
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License Number State | ID
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Taxonomy #3
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number | 23743
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License Number State | TX
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Taxonomy #4
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number | 23743
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License Number State | TX
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