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Physician Compare National (NPI:1356774392)

HEALTHCARE PROVIDER: MEI SAN LAM O.D.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information

NPI 1356774392
Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID 1153557004
Unique individual clinician ID assigned by PECOS
Professional Enrollment ID I20131122001627
Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name LAM
Individual professional last name
Provider First Name MEI
Individual professional first name
Provider Middle Name S
Individual professional middle name
Provider Gender F
The provider's gender if the provider is a person.

Medical School Information

Medical School Name OTHER
Individual professional's medical school
Graduation Year 2013
Individual professional's medical school graduation year
Primary Specialty OPTOMETRY
Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information

Organization Legal Name MARTIN WEDEL AND BULLARD OD PC
Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID 4385628502
Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members 9
Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address 839 N NOLAN RIVER RD
Group Practice or individual's line 1 address
Line 2 Street Address CLEBURNE EYE CLINIC
Group Practice or individual's line 2 address
City CLEBURNE
Group Practice or individual's city
State TX
Group Practice or individual's state
Zip Code 760337001
Group Practice or individual's zip code (9 digits when available)
Phone Number 8176452411
Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information

Professional Accepts Medicare Assignment Y

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