Healthcare Provider Details

I. General information

NPI: 1023981818
Provider Name (Legal Business Name): LYDIA ANIMOS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/26/2025
Last Update Date: 09/26/2025
Certification Date: 09/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2177 BUCKINGHAM RD # 483
RICHARDSON TX
75081-5484
US

IV. Provider business mailing address

2177 BUCKINGHAM RD # 483
RICHARDSON TX
75081-5484
US

V. Phone/Fax

Practice location:
  • Phone: 945-312-2396
  • Fax:
Mailing address:
  • Phone: 945-312-2396
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172A00000X
TaxonomyDriver
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: