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1043990104
ETHAN LAM
BRYAN, TX
NPI
1043990104
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
Enumeration Date
2023-07-24
Last Update Date
2023-07-24
Business Address
ETHAN LAM
3450 CAMPUS DR
BRYAN, TX 77802-3300
Phone number: 979-209-2400
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Mailing Address
ETHAN LAM
19515 SALADO CREEK CT
CYPRESS, TX 77433-3968
Phone number: 832-420-5735
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