Provider Demographics
NPI:1306827308
Name:MYERS, LYNN M (MD)
Entity Type:Individual
Prefix:
First Name:LYNN
Middle Name:M
Last Name:MYERS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8440 WALNUT HILL LN STE 600
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-3824
Mailing Address - Country:US
Mailing Address - Phone:214-345-5999
Mailing Address - Fax:214-345-5988
Practice Address - Street 1:8440 WALNUT HILL LN STE 600
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-3824
Practice Address - Country:US
Practice Address - Phone:214-345-5999
Practice Address - Fax:214-345-5988
Is Sole Proprietor?:No
Enumeration Date:2005-11-08
Last Update Date:2012-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH0944207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX118470704Medicaid
TXTXB160700Medicare PIN
TXTXB160625Medicare PIN
85C107Medicare ID - Type Unspecified
TX8G9024Medicare ID - Type Unspecified
TXTXB160698Medicare PIN
TX118470704Medicaid