1801665302 NPI number — TRISTAN AND DAUN LAI M.D., P.A.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1801665302 NPI number — TRISTAN AND DAUN LAI M.D., P.A.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TRISTAN AND DAUN LAI M.D., P.A.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1801665302
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/18/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
19750 STATE HIGHWAY 46 W STE 104
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SPRING BRANCH
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78070-6881
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
210-382-3039
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
19750 STATE HIGHWAY 46 W STE 104
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SPRING BRANCH
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78070-6881
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
210-382-3039
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/26/2023

Additional Information

Authorized Official

Authorized Official Last Name:
LAI
Authorized Official First Name:
DAUN
Authorized Official Middle Name:
Authorized Official Title or Position:
PHYSICIAN
Authorized Official Telephone Number:
210-382-3039

Provider Taxonomy Codes

  • Taxonomy code: 207L00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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