MEDICARE: DR. MICHAEL HYDER LIMERICK PHD RN ACNS-BC CHPN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	364SA2200X	Adult Health Clinical Nurse Specialist	257003	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1134125990
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL HYDER LIMERICK PHD RN ACNS-BC CHPN

Provider Business Mailing Address
First Line	:	3356 LOCKMOOR LN
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75220-1634
Country	:	US
Telephone Number	:	512-296-0892
Fax Number	:

Provider Business Practice Location Address
First Line	:	7777 FOREST LN
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75230-2571
Country	:	US
Telephone Number	:	972-566-6119
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/24/2005
Last Update Date	:	03/09/2022

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