Provider Demographics
NPI:1225239965
Name:LI, LILY Y (MD)
Entity Type:Individual
Prefix:
First Name:LILY
Middle Name:Y
Last Name:LI
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:2261 BROOKHOLLOW DRIVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76006
Mailing Address - Country:US
Mailing Address - Phone:817-962-2156
Mailing Address - Fax:817-633-1916
Practice Address - Street 1:811 W I-20
Practice Address - Street 2:SUITE G40
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76017-5870
Practice Address - Country:US
Practice Address - Phone:817-466-8651
Practice Address - Fax:817-466-2503
Is Sole Proprietor?:No
Enumeration Date:2007-05-30
Last Update Date:2012-08-15
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Provider Licenses
StateLicense IDTaxonomies
TXN3834207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXB151187Medicare PIN