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General NPI Number Information
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NPI Number | 1306071402
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Entity Type | Individual
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Provider Name | ANTHONY LEE LYSSY DO
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Gender | Male
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Dates
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Enumeration Date | 05/19/2009
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Last Update Date | 01/30/2020
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Provider Practice Location Address
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Address Line | 5950 BERKSHIRE LN STE 225
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City | DALLAS
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State | TX
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Zip | 75225-5857
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Country | US
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Telephone | 214-550-2090
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Fax | 888-502-1190
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Provider Business Mailing Address
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Address Line | 5950 BERKSHIRE LN STE 225
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City | DALLAS
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State | TX
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Zip | 75225-5857
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Country | US
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Telephone | 214-550-2090
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Fax | 888-502-1190
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | N8031
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License Number State | TX
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