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General NPI Number Information
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NPI Number | 1245898634
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Entity Type | Individual
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Provider Name | KIMBERLY VAN LAM NP
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Gender | Female
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Dates
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Enumeration Date | 05/31/2019
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Last Update Date | 04/05/2022
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Provider Practice Location Address
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Address Line | 455 SCHOOL ST STE 20
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City | TOMBALL
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State | TX
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Zip | 77375-4597
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Country | US
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Telephone | 812-357-5678
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Fax |
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Provider Business Mailing Address
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Address Line | 11951 LAUREL MEADOW DR
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City | TOMBALL
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State | TX
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Zip | 77377-8586
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Country | US
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Telephone | 832-341-1100
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP141470
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License Number State | TX
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