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General NPI Number Information
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NPI Number | 1851203723
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Entity Type | Individual
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Provider Name | DAT TAN LAM
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Gender | Male
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Dates
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Enumeration Date | 09/17/2026
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Last Update Date | 09/17/2026
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Provider Practice Location Address
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Address Line | 2250 MCGREGOR PARK CIRCLE
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City | FORT MYERS
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State | FL
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Zip | 33908
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Country | US
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Telephone | 888-499-5672
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Fax |
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Provider Business Mailing Address
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Address Line | 935 CARTHAGE WAY
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City | ARLINGTON
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State | TX
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Zip | 76017-6552
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Country | US
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Telephone | 682-552-6405
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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 | 242T00000X
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Taxonomy Name | Perfusionist
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License Number | LP152
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License Number State | NV
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