Organization
SHIVA KUMAR LAM, MD, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALLIE LAM (OFFICE MANAGER)
(512) 467-2840
Entity
Organization
Contact information
Practice address
1407 W STASSNEY LN, AUSTIN, TX 78745-2947
(512) 440-4800
(512) 440-4836
Mailing address
P. O. BOX 26100, AUSTIN, TX 78755
(512) 467-2840
(512) 692-9158
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
—
—
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
096990903
—
TX
05
—
305165801
—
TX
05
—
305165802
—
TX
01
—
TXB144748
MEDICARE
—
01
—
TXB144749
MEDICARE
—
Enumeration date
12/09/2010
Last updated
09/30/2022
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