Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0300X | Periodontist | 23138 | TX |
NPI | 1053438713 |
---|---|
Provider Name | Dr. Lillian Carmina Lyons |
First Address | The Woodlands, TX 77384-4099 |
Second Address | The Woodlands, TX 77384-4099 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/03/2007 |
Last Update Date | 27/02/2015 |