MEDICARE: LAMM DAVID EYECARE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1497024186
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LAMM DAVID EYECARE

Provider Business Mailing Address
First Line	:	3542A LOOP 306
Second Line	:
City	:	SAN ANGELO
State	:	TX
Zip	:	76904-5944
Country	:	US
Telephone Number	:	325-653-0118
Fax Number	:	325-653-0118

Provider Business Practice Location Address
First Line	:	3542A LOOP 306
Second Line	:
City	:	SAN ANGELO
State	:	TX
Zip	:	76904-5944
Country	:	US
Telephone Number	:	325-653-0118
Fax Number	:	325-653-4347

Authorized Official
Title or Position	:	MANAGER
Name	:	MELINDA WILLIAMSON
Credential	:
Telephone Number	:	325-653-0118

Provider Enumeration Date	:	12/24/2011
Last Update Date	:	06/07/2019

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Directions to “LAMM DAVID EYECARE ” Practice Location

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