Provider Demographics
NPI:1255307120
Name:APPIAH-DWAMENA, LYDIA (MD)
Entity Type:Individual
Prefix:DR
First Name:LYDIA
Middle Name:
Last Name:APPIAH-DWAMENA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:LYDIA
Other - Middle Name:
Other - Last Name:APPIAH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:102 PALO ALTO RD
Mailing Address - Street 2:SUITE 230
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78211-3758
Mailing Address - Country:US
Mailing Address - Phone:210-922-3331
Mailing Address - Fax:210-922-3339
Practice Address - Street 1:102 PALO ALTO RD
Practice Address - Street 2:SUITE 230
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78211-3758
Practice Address - Country:US
Practice Address - Phone:210-922-3331
Practice Address - Fax:210-922-3339
Is Sole Proprietor?:No
Enumeration Date:2006-02-28
Last Update Date:2012-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL7963207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX165548503Medicaid
TX165448503Medicaid
TX165548503Medicaid
00Z554Medicare PIN
105031Medicare UPIN
TX165448503Medicaid