MEDICARE: AMBER DELAINE HYDE M.D.

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	207Q00000X	Family Medicine Physician	BP10021782	TX
2	207Q00000X	Family Medicine Physician	26749	OK
3	207Q00000X	Family Medicine Physician	N4487	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	8CW739	OTHER	TX	BLUE CROSS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1902083082
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMBER DELAINE HYDE M.D.

Provider Business Mailing Address
First Line	:	3021 GATEWAY DR STE 295
Second Line	:
City	:	IRVING
State	:	TX
Zip	:	75063-2639
Country	:	US
Telephone Number	:	469-351-6136
Fax Number	:

Provider Business Practice Location Address
First Line	:	3021 GATEWAY DR STE 295
Second Line	:
City	:	IRVING
State	:	TX
Zip	:	75063-2639
Country	:	US
Telephone Number	:	469-351-6136
Fax Number	:

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

Provider Enumeration Date	:	01/30/2008
Last Update Date	:	05/15/2020

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