Provider Demographics
NPI:1134333479
Name:LAM, WAI G (MSPT)
Entity type:Individual
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First Name:WAI
Middle Name:G
Last Name:LAM
Suffix:
Gender:M
Credentials:MSPT
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Mailing Address - Street 1:4910 AIRPORT AVE
Mailing Address - Street 2:BUILDING D
Mailing Address - City:ROSENBERG
Mailing Address - State:TX
Mailing Address - Zip Code:77471-5759
Mailing Address - Country:US
Mailing Address - Phone:281-239-1369
Mailing Address - Fax:281-239-0828
Practice Address - Street 1:3634 GLENN LAKES LN
Practice Address - Street 2:SUITE 200
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77459-4062
Practice Address - Country:US
Practice Address - Phone:281-208-6620
Practice Address - Fax:281-261-2584
Is Sole Proprietor?:No
Enumeration Date:2007-05-09
Last Update Date:2007-07-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TX1129211225100000X, 2251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Not Answered2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX85674TOtherTEXANA BCBS