Individual
TIFFANY LAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4300 SIGMA RD STE 120, FARMERS BRANCH, TX 75244-4422
(214) 483-9933
Mailing address
4812 PORTRAIT LN, PLANO, TX 75024-3803
(972) 890-8863
Taxonomy
Speciality
Code
Description
License number
State
374700000X
Technician
Primary
122018
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
GAH01003161104
THUMANN AGENCY
—
Enumeration date
11/21/2017
Last updated
11/21/2017
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