Individual
DR. COLLIN EDWARD TAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
4800 BURNET RD STE A-100, AUSTIN, TX 78756-2800
(512) 407-9002
(512) 309-5382
Mailing address
12918 STEEPLE CHASE DR, AUSTIN, TX 78729-7336
(512) 331-4096
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
10172
CA
152W00000X
Optometrist
413
HI
152W00000X
Optometrist
Primary
4880TG
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PO80287E
—
TX
Enumeration date
08/30/2007
Last updated
10/23/2013
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