Individual
MR. TIANJIE LAI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
9201 PINECROFT DR, SHENANDOAH, TX 77380-3222
(936) 441-1010
Mailing address
920 MEDICAL PLAZA DR STE 360, SHENANDOAH, TX 77380-3271
(281) 803-8482
(281) 803-8432
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA03947
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
190194401
—
TX
01
—
8Y1782
BCBS OF TEXAS
TX
01
—
P00414114
RAILROAD MEDICARE
GA
Enumeration date
03/13/2007
Last updated
02/14/2018
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