Individual
DR. SHIVA KUMAR LAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1407 W STASSNEY LN, AUSTIN, TX 78745-2947
(512) 440-4800
(512) 440-4836
Mailing address
PO BOX 26100, AUSTIN, TX 78755-0100
(512) 467-2840
(512) 692-9158
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
K4933
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
096990902
—
TX
05
—
305165801
—
TX
05
—
305165802
—
TX
01
—
TXB144748
MEDICARE
TX
01
—
TXB144749
MEDICARE
TX
Enumeration date
11/02/2006
Last updated
09/30/2022
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