Provider Demographics
NPI:1871859363
Name:PAM CHIN-LAI, INC
Entity Type:Organization
Organization Name:PAM CHIN-LAI, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIETITAN
Authorized Official - Prefix:
Authorized Official - First Name:PAM
Authorized Official - Middle Name:
Authorized Official - Last Name:CHIN-LAI
Authorized Official - Suffix:
Authorized Official - Credentials:RD LD
Authorized Official - Phone:972-930-0766
Mailing Address - Street 1:17300 PRESTON RD
Mailing Address - Street 2:SUITE 160
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75252-5654
Mailing Address - Country:US
Mailing Address - Phone:972-930-0766
Mailing Address - Fax:972-733-6564
Practice Address - Street 1:17300 PRESTON RD
Practice Address - Street 2:SUITE 160
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75252-5654
Practice Address - Country:US
Practice Address - Phone:972-930-0766
Practice Address - Fax:972-733-6564
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-09
Last Update Date:2012-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT 03252133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty