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General NPI Number Information
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NPI Number | 1689344491
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Entity Type | Individual
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Provider Name | ESTEFFANIA ADRIANA LEZAMA PHD
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Gender | Female
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Dates
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Enumeration Date | 09/14/2021
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Last Update Date | 09/14/2021
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Provider Practice Location Address
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Address Line | 8350 N CENTRAL EXPY STE 1275
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City | DALLAS
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State | TX
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Zip | 75206-1614
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Country | US
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Telephone | 214-302-7373
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Fax |
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Provider Business Mailing Address
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Address Line | 6202 GASTON AVE # 4B
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City | DALLAS
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State | TX
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Zip | 75214-7306
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Country | US
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Telephone | 915-274-4598
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 38843
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License Number State | TX
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