MEDICARE: MR. VINCENT WING-WAH LAM O.D.

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	152W00000X	Optometrist	7406TG	TX

General Provider Information

NPI Number	:	1841524063
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. VINCENT WING-WAH LAM O.D.

Provider Business Mailing Address
First Line	:	2211 VILLAGE DALE AVE
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77059-3591
Country	:	US
Telephone Number	:	832-605-7103
Fax Number	:	409-883-8012

Provider Business Practice Location Address
First Line	:	306 MAGNOLIA BLVD
Second Line	:
City	:	MAGNOLIA
State	:	TX
Zip	:	77355-8535
Country	:	US
Telephone Number	:	281-259-2020
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/21/2009
Last Update Date	:	09/24/2024

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Directions to “ MR. VINCENT WING-WAH LAM O.D.” Practice Location

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