Provider Demographics
NPI:1053742163
Name:TAM, LIANA (DDS)
Entity type:Individual
Prefix:DR
First Name:LIANA
Middle Name:
Last Name:TAM
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10128 HAMMERLY BLVD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77080-5010
Mailing Address - Country:US
Mailing Address - Phone:713-464-4774
Mailing Address - Fax:
Practice Address - Street 1:7670 KATY FWY STE 30
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-2254
Practice Address - Country:US
Practice Address - Phone:713-681-6100
Practice Address - Fax:281-929-0410
Is Sole Proprietor?:No
Enumeration Date:2013-11-29
Last Update Date:2022-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA627561223G0001X
TX296911223G0001X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice