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NPI Code Detail

MEDICARE: DR. LYDIA R ESSARY MD

MEDICARE: DR. LYDIA R ESSARY MD
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
1207ND0900XDermatopathology PhysicianK8136TX
2207N00000XDermatology PhysicianK8136TX

Other Identifiers

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

General Provider Information

NPI Number : 1225018286
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LYDIA R ESSARY MD
Provider Business Mailing Address
First Line : 1790 N STONEBRIDGE DR
Second Line :
City : MCKINNEY
State : TX
Zip : 75071-7437
Country : US
Telephone Number : 972-390-9002
Fax Number : 214-491-3777
Provider Business Practice Location Address
First Line : 1790 N STONEBRIDGE DR
Second Line :
City : MCKINNEY
State : TX
Zip : 75071-7437
Country : US
Telephone Number : 972-390-9002
Fax Number : 214-491-3777
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/18/2006
Last Update Date : 03/22/2017

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Directions to “ DR. LYDIA R ESSARY MD” Practice Location

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