Provider Demographics
NPI:1982358966
Name:LAM, LIANA (FNP-C)
Entity type:Individual
Prefix:
First Name:LIANA
Middle Name:
Last Name:LAM
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:MS
Other - First Name:LIANA
Other - Middle Name:
Other - Last Name:KAM
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:FNP-C
Mailing Address - Street 1:3322 MEADOW WOOD DR
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75082-3788
Mailing Address - Country:US
Mailing Address - Phone:972-971-3971
Mailing Address - Fax:
Practice Address - Street 1:5225 BELT LINE RD STE 208
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75254-1436
Practice Address - Country:US
Practice Address - Phone:469-312-2993
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-08
Last Update Date:2022-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1068250363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily