Provider Demographics
NPI:1285188698
Name:LAM, ANDREA (DMD)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:
Last Name:LAM
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2990 RICHMOND AVE STE 170
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77098-3104
Mailing Address - Country:US
Mailing Address - Phone:832-271-8033
Mailing Address - Fax:713-750-9052
Practice Address - Street 1:2990 RICHMOND AVE STE 170
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77098-3104
Practice Address - Country:US
Practice Address - Phone:832-271-8033
Practice Address - Fax:713-750-9052
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-15
Last Update Date:2020-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX322641223G0001X, 1223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
No1223G0001XDental ProvidersDentistGeneral Practice