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General NPI Number Information
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NPI Number | 1033126545
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Entity Type | Individual
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Provider Name | DIANE MARIE LYLE R.PH, PHARM.D
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Gender | Female
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Dates
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Enumeration Date | 08/01/2006
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Last Update Date | 03/03/2011
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Provider Practice Location Address
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Address Line | 4500 S LANCASTER RD PATIENT SAFETY - EXECUTIVE OFFICE (00PS)
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City | DALLAS
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State | TX
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Zip | 75216-7167
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Country | US
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Telephone | 214-857-2219
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Fax |
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Provider Business Mailing Address
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Address Line | 276 LOMA RD
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City | BEDIAS
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State | TX
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Zip | 77831-3161
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Country | US
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Telephone | 936-874-2805
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 30646
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 03-3-16867
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License Number State | OH
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