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General NPI Number Information
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NPI Number | 1477594042
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Entity Type | Individual
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Provider Name | CAROLYN B LYDE MD
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Gender | Female
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Dates
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Enumeration Date | 06/08/2006
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Last Update Date | 03/12/2008
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Provider Practice Location Address
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Address Line | 324 W MAIN ST SUITE 330
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City | LEWISVILLE
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State | TX
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Zip | 75057
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Country | US
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Telephone | 972-436-0358
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Fax | 972-353-3750
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Provider Business Mailing Address
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Address Line | 324 W MAIN ST SUITE 200
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City | LEWISVILLE
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State | TX
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Zip | 75057-3641
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Country | US
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Telephone | 972-436-0358
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Fax | 972-353-3750
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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 | 207NS0135X
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Taxonomy Name | Procedural Dermatology Physician
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License Number | H0585
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License Number State | TX
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