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General NPI Number Information
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NPI Number | 1992022594
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Entity Type | Individual
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Provider Name | LILY FATHY PRIMO M.D
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Gender | Female
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Dates
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Enumeration Date | 04/23/2010
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Last Update Date | 09/22/2015
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Provider Practice Location Address
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Address Line | 6900 SCENIC DR SUITE 101
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City | ROWLETT
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State | TX
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Zip | 75088-2695
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Country | US
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Telephone | 972-475-7122
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Fax | 972-412-0935
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Provider Business Mailing Address
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Address Line | 6900 SCENIC DR SUITE 101
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City | ROWLETT
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State | TX
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Zip | 75088-2695
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Country | US
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Telephone | 972-475-7122
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Fax | 972-412-0935
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | P9937
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License Number State | TX
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