Provider Demographics
NPI:1821541665
Name:LAM, SWARNA
Entity Type:Individual
Prefix:
First Name:SWARNA
Middle Name:
Last Name:LAM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SWARNA
Other - Middle Name:SAMUEL
Other - Last Name:BATHINI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1108 E MULBERRY ST STE A
Mailing Address - Street 2:
Mailing Address - City:ANGLETON
Mailing Address - State:TX
Mailing Address - Zip Code:77515-3955
Mailing Address - Country:US
Mailing Address - Phone:979-849-9740
Mailing Address - Fax:979-849-1094
Practice Address - Street 1:1108 E MULBERRY ST STE A
Practice Address - Street 2:
Practice Address - City:ANGLETON
Practice Address - State:TX
Practice Address - Zip Code:77515-3955
Practice Address - Country:US
Practice Address - Phone:979-849-9740
Practice Address - Fax:979-849-1094
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-28
Last Update Date:2016-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP131479363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily