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General NPI Number Information
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NPI Number | 1801026653
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Entity Type | Individual
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Provider Name | LYDIA CECILIA AUSBERRY D.D.S.
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Gender | Female
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Dates
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Enumeration Date | 07/14/2009
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Last Update Date | 08/29/2025
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Provider Practice Location Address
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Address Line | 6628 LAKE WORTH BLVD STE 200
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City | LAKE WORTH
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State | TX
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Zip | 76135-3020
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Country | US
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Telephone | 817-238-7984
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Fax |
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Provider Business Mailing Address
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Address Line | 115 W STAGECOACH TRL
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City | WEATHERFORD
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State | TX
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Zip | 76085-8356
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Country | US
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Telephone | 202-378-7089
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 41186
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License Number State | TX
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