Provider Demographics
NPI:1942341078
Name:LAM, SATOKO ELISA (PT)
Entity type:Individual
Prefix:MISS
First Name:SATOKO
Middle Name:ELISA
Last Name:LAM
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2402 MYSTIC TRL
Mailing Address - Street 2:
Mailing Address - City:ROWLETT
Mailing Address - State:TX
Mailing Address - Zip Code:75088-2428
Mailing Address - Country:US
Mailing Address - Phone:808-753-7651
Mailing Address - Fax:
Practice Address - Street 1:2402 MYSTIC TRL
Practice Address - Street 2:
Practice Address - City:ROWLETT
Practice Address - State:TX
Practice Address - Zip Code:75088-2428
Practice Address - Country:US
Practice Address - Phone:808-753-7651
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-10
Last Update Date:2015-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPT-2352225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI0000255026OtherHMSA