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1023311321

NPI Code Detail

MEDICARE: SHIVA KUMAR LAM, MD, PA

MEDICARE: SHIVA KUMAR LAM, MD, PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician
2	2084P0804X	Child & Adolescent Psychiatry Physician

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	TXB144749	OTHER		MEDICARE
4	TXB144748	OTHER		MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1023311321
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SHIVA KUMAR LAM, MD, PA

Provider Business Mailing Address
First Line	:	P. O. BOX 26100
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78755
Country	:	US
Telephone Number	:	512-467-2840
Fax Number	:	512-692-9158

Provider Business Practice Location Address
First Line	:	1407 W STASSNEY LN
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78745-2947
Country	:	US
Telephone Number	:	512-440-4800
Fax Number	:	512-440-4836

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	ALLIE LAM
Credential	:
Telephone Number	:	512-467-2840

Provider Enumeration Date	:	12/09/2010
Last Update Date	:	09/30/2022

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Directions to “SHIVA KUMAR LAM, MD, PA ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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