Healthcare Provider Details

I. General information

NPI: 1700073509
Provider Name (Legal Business Name): ALICE LAM OBRIEN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/26/2007
Last Update Date: 04/12/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1504 TAUB LOOP
HOUSTON TX
77030-1608
US

IV. Provider business mailing address

1 BAYLOR PLZ DEPT OF ANESTHESIOLOGY MS120
HOUSTON TX
77030-3411
US

V. Phone/Fax

Practice location:
  • Phone: 713-873-2900
  • Fax: 713-795-0117
Mailing address:
  • Phone: 713-798-2718
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberM5423
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: