=====================================================
General NPI Number Information
=====================================================
NPI Number | 1437606753
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | LIEN LAM, O.D., PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/02/2016
-----------------------------------------------------
Last Update Date | 09/02/2016
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2601 PRESTON RD STE 1126
-----------------------------------------------------
City | FRISCO
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75034-9472
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 972-731-9859
-----------------------------------------------------
Fax | 972-731-9865
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2601 PRESTON RD STE 1126
-----------------------------------------------------
City | FRISCO
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75034-9472
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 972-731-9859
-----------------------------------------------------
Fax | 972-731-9865
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DOCTOR
-----------------------------------------------------
Name | LIEN LAM
-----------------------------------------------------
Credential | O.D.
-----------------------------------------------------
Telephone | 972-731-9859
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 152W00000X
-----------------------------------------------------
Taxonomy Name | Optometrist
-----------------------------------------------------
License Number | 6162TG
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------