Provider Demographics
NPI:1407293137
Name:SAGAR, LYDIA (PSYD)
Entity Type:Individual
Prefix:DR
First Name:LYDIA
Middle Name:
Last Name:SAGAR
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1914 WOOD CREEK DR
Mailing Address - Street 2:
Mailing Address - City:GRAPEVINE
Mailing Address - State:TX
Mailing Address - Zip Code:76051-7056
Mailing Address - Country:US
Mailing Address - Phone:682-289-0546
Mailing Address - Fax:855-658-1426
Practice Address - Street 1:7165 COLLEYVILLE BLVD STE 101
Practice Address - Street 2:
Practice Address - City:COLLEYVILLE
Practice Address - State:TX
Practice Address - Zip Code:76034-8009
Practice Address - Country:US
Practice Address - Phone:682-289-0546
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-04
Last Update Date:2023-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX36413103TC1900X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling