MEDICARE: MR. JAMES MICHAEL LLOYD DDS

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	1223P0221X	Pediatric Dentistry	13549	TX

General Provider Information

NPI Number	:	1356456602
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JAMES MICHAEL LLOYD DDS

Provider Business Mailing Address
First Line	:	3851 SW GREEN OAKS BLVD
Second Line	:	123
City	:	ARLINGTON
State	:	TX
Zip	:	76017-4130
Country	:	US
Telephone Number	:	817-483-2445
Fax Number	:	817-483-2677

Provider Business Practice Location Address
First Line	:	3851 SW GREEN OAKS BLVD
Second Line	:	123
City	:	ARLINGTON
State	:	TX
Zip	:	76017-4130
Country	:	US
Telephone Number	:	817-483-2445
Fax Number	:	817-483-2677

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

Provider Enumeration Date	:	08/20/2006
Last Update Date	:	11/06/2013

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