Provider Demographics
NPI:1225828031
Name:LAMBETH, RAYMOND LEE (LMT)
Entity type:Individual
Prefix:
First Name:RAYMOND
Middle Name:LEE
Last Name:LAMBETH
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3560 DELAWARE ST STE 501
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77706-3061
Mailing Address - Country:US
Mailing Address - Phone:409-626-1811
Mailing Address - Fax:
Practice Address - Street 1:3560 DELAWARE ST STE 501
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77706-3061
Practice Address - Country:US
Practice Address - Phone:409-626-1811
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-07
Last Update Date:2025-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXMT144571225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist