Gamble, Lisa Lynelle

Gamble, Lisa Lynelle is an individual health care provider with primary practice located at 800 E Dawson St , Tyler TX 75701-2036. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Critical Care Medicine, Allopathic & Osteopathic Physicians / Pulmonary Disease. Allopathic & Osteopathic Physicians / Pulmonary Disease is her primary health care specialty. Gamble, Lisa Lynelle can be contacted via phone (903) 525-1914.

Contact Information

Primary practice address
800 E Dawson St Tyler TX 75701-2036
Phone: (903) 525-1914
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Critical Care Medicine 207RC0200X 23658 Louisiana
Allopathic & Osteopathic Physicians / Pulmonary Disease 207RP1001X 23658 Louisiana
Allopathic & Osteopathic Physicians / Pulmonary Disease 207RP1001X Q0047 Texas

Profile Details

NPI number 1710998232
LBN Legal business name Gamble, Lisa Lynelle
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 10th, 2006
Last updated Jun 12th, 2017 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1710998232 NPPES
Texas Other 752616977042 TRICARE
Texas MEDICAID 09050308 TRICARE
Texas MEDICAID 369671801 TRICARE
Texas MEDICAID 1484164 TRICARE
Texas Other 8GM927 TRICARE
Texas Other P01831137 TRICARE

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