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General NPI Number Information
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NPI Number | 1063700763
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Entity Type | Organization
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Legal Business Name | LYDIA BISHOP, M.D., P.A.
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Dates
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Enumeration Date | 07/14/2011
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Last Update Date | 09/04/2014
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Provider Practice Location Address
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Address Line | 601 OMEGA DRIVE SUITE 204
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City | ARLINGTON
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State | TX
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Zip | 76014
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Country | US
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Telephone | 817-473-7278
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Fax | 817-225-1920
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Provider Business Mailing Address
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Address Line | 601 OMEGA DRIVE SUITE 204
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City | ARLINGTON
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State | TX
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Zip | 76014
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Country | US
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Telephone | 817-473-7278
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Fax | 817-225-1920
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Authorized Official
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Title or Position | PRES/SEC'Y
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Name | LYDIA ANN BISHOP
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Credential | MD
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Telephone | 817-473-7278
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | J3994
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License Number State | TX
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