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NPI Code Detail

MEDICARE: DR. LYNN AZUMA M.D.

MEDICARE: DR. LYNN AZUMA M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208000000XPediatrics Physician233324NY
2208000000XPediatrics PhysicianM6508TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1295782043
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LYNN AZUMA M.D.
Provider Business Mailing Address
First Line : PO BOX 844658
Second Line :
City : DALLAS
State : TX
Zip : 75284-4658
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 425 UNIVERSITY BLVD
Second Line : SUITE 130
City : ROUND ROCK
State : TX
Zip : 78665-1053
Country : US
Telephone Number : 512-509-0200
Fax Number : 512-509-3514
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/27/2006
Last Update Date : 09/10/2020

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Directions to “ DR. LYNN AZUMA M.D.” Practice Location

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