Provider Demographics
NPI:1073546172
Name:LYLES, CATHERINE LYNN (DMD)
Entity Type:Individual
Prefix:DR
First Name:CATHERINE
Middle Name:LYNN
Last Name:LYLES
Suffix:
Gender:F
Credentials:DMD
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Mailing Address - Street 1:13032 NACOGDOCHES RD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78217-1981
Mailing Address - Country:US
Mailing Address - Phone:210-590-8858
Mailing Address - Fax:210-590-4981
Practice Address - Street 1:13032 NACOGDOCHES RD
Practice Address - Street 2:SUITE 202
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78217-1981
Practice Address - Country:US
Practice Address - Phone:210-590-8858
Practice Address - Fax:210-590-4981
Is Sole Proprietor?:No
Enumeration Date:2006-07-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX173491223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry