Individual provider Active NPI

Tony Lam, CST

  • Surgical Technologist
  • Dallas, TX
National Provider Identifier
1053997080
Registry record updated Mar 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical TechnologistTaxonomy code 246ZS0410X
License
343910 Issued in TX
Practice address
3500 Gaston Ave
Dallas, TX 75246-2088
Phone
(884) 279-3627
NPI assigned
Mar 21, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Technologist 246ZS0410X 343910 TX Primary

Addresses

Primary practice location

3500 Gaston Ave
Dallas, TX 75246-2088

Mailing address

712 Craig St
Irving, TX 75060-3989
Phone (972) 768-3282

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
343910TXMDSurgical Technologist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1616284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616284800000",
    "number": "1053997080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "712 CRAIG ST",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750603989",
            "telephone_number": "972-768-3282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3500 GASTON AVE",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752462088",
            "telephone_number": "884-279-3627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAM",
        "first_name": "TONY",
        "credential": "CST",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-21",
        "last_updated": "2021-03-21",
        "certification_date": "2021-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246ZS0410X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Technologist",
            "state": "TX",
            "license": "343910",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.