Provider Demographics
NPI:1336321207
Name:LYDE, PAUL DANIEL (MD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:DANIEL
Last Name:LYDE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:6750 N MACARTHUR BLVD
Mailing Address - Street 2:STE 350
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75039-2484
Mailing Address - Country:US
Mailing Address - Phone:972-556-1616
Mailing Address - Fax:972-556-1740
Practice Address - Street 1:6750 N MACARTHUR BLVD
Practice Address - Street 2:STE 350
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75039-2484
Practice Address - Country:US
Practice Address - Phone:972-556-1616
Practice Address - Fax:972-556-1740
Is Sole Proprietor?:No
Enumeration Date:2007-12-03
Last Update Date:2019-11-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXH0586207RE0101X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX123134206Medicaid
TX8K4685Medicare PIN