Basic Information
Provider Information | |||||||||
NPI: | 1679731202 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | LAMBERT | ||||||||
FirstName: | EDDIE | ||||||||
MiddleName: | L | ||||||||
NamePrefix: | DR. | ||||||||
NameSuffix: |   | ||||||||
Credential: | M.D. | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | 13811 MURPHY RD | ||||||||
Address2: |   | ||||||||
City: | STAFFORD | ||||||||
State: | TX | ||||||||
PostalCode: | 774774903 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 7137721200 | ||||||||
FaxNumber: | 7135830505 | ||||||||
Practice Location | |||||||||
Address1: | 10970 SHADOW CREEK PKWY STE 220 | ||||||||
Address2: |   | ||||||||
City: | PEARLAND | ||||||||
State: | TX | ||||||||
PostalCode: | 775840102 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 7137721200 | ||||||||
FaxNumber: | 8327647665 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 05/30/2008 | ||||||||
LastUpdateDate: | 06/14/2021 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | M | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: | 06/14/2021 |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | ME116330 | FL | N |   | Allopathic & Osteopathic Physicians | Surgery |   | 208C00000X | ME116330 | FL | N |   | Allopathic & Osteopathic Physicians | Colon & Rectal Surgery |   | 208C00000X | P6990 | TX | N |   | Allopathic & Osteopathic Physicians | Colon & Rectal Surgery |   | 390200000X | TRN12571 | FL | N |   | Student, Health Care | Student in an Organized Health Care Education/Training Program |   | 208600000X | P6990 | TX | Y |   | Allopathic & Osteopathic Physicians | Surgery |   |
ID Information
ID | Type | State | Issuer | Description | 331103709 | 05 | TX |   | MEDICAID | 8EB431 | 01 | TX | BCBS (MDACC) | OTHER |