Provider Demographics
NPI:1871622050
Name:LAMBERT, CAROL ANN (OTR)
Entity type:Individual
Prefix:MS
First Name:CAROL
Middle Name:ANN
Last Name:LAMBERT
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:269 COUNTY ROAD 3589
Mailing Address - Street 2:
Mailing Address - City:WINNSBORO
Mailing Address - State:TX
Mailing Address - Zip Code:75494-5072
Mailing Address - Country:US
Mailing Address - Phone:903-857-2368
Mailing Address - Fax:
Practice Address - Street 1:1200 DUDLEY RD
Practice Address - Street 2:
Practice Address - City:KILGORE
Practice Address - State:TX
Practice Address - Zip Code:75662-3306
Practice Address - Country:US
Practice Address - Phone:903-984-5571
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX100835261QR0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0401XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)