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General NPI Number Information
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NPI Number | 1033592951
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Entity Type | Organization
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Legal Business Name | MYRON S. LAZAR PH.D., P.C.
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Dates
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Enumeration Date | 07/09/2015
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Last Update Date | 07/09/2015
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Provider Practice Location Address
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Address Line | 8330 MEADOW RD SUITE 202
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City | DALLAS
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State | TX
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Zip | 75231-3767
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Country | US
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Telephone | 972-979-2779
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Fax |
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Provider Business Mailing Address
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Address Line | 8330 MEADOW RD SUITE 202
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City | DALLAS
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State | TX
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Zip | 75231-3767
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Country | US
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Telephone | 972-979-2779
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MYRON S. LAZAR
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Credential | PH.D.
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Telephone | 214-691-1153
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 102L00000X
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Taxonomy Name | Psychoanalyst
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103TP0814X
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Taxonomy Name | Psychoanalysis Psychologist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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